The relationship between the BODE score in stable moderate to severe chronic obstructive pulmonary disease and the pathogenic bacteria detected in secondly acute exacerbation

Abstract

Objective To investigate the scores of BODE index in stable moderate to severe chronic obstructive pulmonary disease(COPD) and their relationship to the distribution and resistance of the pathogens detected in secondly acute exacerbations of COPD.Methods Ninty-seven patients (42 with moderate and 55 with severe COPD) were evaluated for BODE scores in stable phase of COPD,including the routine pulmonary function test,the body mass index,MRC dyspnoea sore,6-minute walt test,the eligible sputum specimen and blood sample were cultured for bacteria and fungi in newly acute exacerbation.All data were statistically analyzed with SPSS 11.5 for windows.Results According to the the BODE scores,32 cases with BODE index score 0-3 were divided into A group,29 cases with score 4-6 were B group,36 cases with score 7-10 were C group.97 cases of sputum culture and blood cultures in patients,a total of 46 strains identified pathogens,including 25 strains of Gram negative bacteria (54.35％),15 strains of Gram positive bacteria (32.61％),6 strains of fungi (13.04％).Patients in C group has higher positive rate of sputum culture and hemoculture than A group (61.1 ％,22/36;25.0 ％,9/36 vs 31.3％,10/32; 6.3％,2/32),(x2 =6.0635,P =0.0138; x2 =4.3923,P =0.036 1).Detection rate of Gram-negative Bacteria in sputum sample from C group was significantly higher than A group (36.1％,13/36 vs 9.4％,3/32; x2 =4.740 7,P =0.029 5).Multi-resistant strains were seen in the cases of group C specimens,compared with group A,the difference was statistically significant (x2=9.220 3,P =0.002 4).Compare the two groups of patients in severe bacterial infections based on simple lung function classification types and multi-resistant incidence,the difference did not reach statistical significance.Conclusions Patients in the stable phase of COPD measured by BODE integral higher again in acute exacerbation,a higher incidence of Gram-negative bacteria infection,and infection may occur more complex. Key words: Pulmonary disease; Chronic obstructive; Pathogens; BODE score