Clinical and laboratory aspects of diagnosis and treatment of chronic obstructive pulmonary disease infectious exacerbations in seniors of the Ministry of Defense of Ukraine

Abstract

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death in the world. The question of antibiotic therapy role during the COPD exacerbation remained for a long time not absolutely certain. It is likely that modern diagnostics, cupping and prevention of exacerbations come to the fore in patient with COPD care. Objective – to examine the role of bacterial pathogens in COPD exacerbation development, to analyze diagnostic and therapeutic measures in Ministry of Defense of Ukraine (MDU) retired patients for the purpose of their optimization. Materials and methods. A retrospective analysis was carried out of 72 stories of MDU retired men diseases, whose average age was (71.1 ± 1.20) years with an average length of disease (7.85 ± 0.51) years. The control group consisted of 20 practically healthy persons. To reveal the etiological structure of the COPD infectious exacerbation, the data of bacteriological sputum examination were used, which included the quantitative detection of the pathogen and its sensitivity to antibacterial drugs. Results. A total of 30 strains of pathogens were obtained. The leading pathogen of COPD infectious exacerbation of MDU retired men turned out the Streptococcus family (53.3 %), such as S. pneumoniae, S. mitis, S. viridans, S. epedermidis and representatives of the Staphylococcus family (16.6 %). Two strains of Ps. Aeruginosa (6.6 %) were found among the entire patients contingent. Conclusions. The leading causes of COPD exacerbations in pensioners of MDU mostly were hypothermia and acute viral respiratory infections – 49.9 %. Only acute viral respiratory infections were in 34.3 % of cases, only hypothermia – in 15.6 %. Physical overstrain and decompensation of concomitant pathology were less often. The most common the types I and II of exacerbations by Anthonisen were observed, which occurred in 44.5 % and 43.0 % of cases, respectively, the III type of exacerbations was found in 12.5 % of cases. The protected aminopenicillins and the III generation cephalosporins have remained high activity against the main pathogens of COPD exacerbation. In patients of the first group with microbiological sputum examination the number of days spent in the hospital (7.5 ± 0.36) was significantly less than in patients of the second group (11.3 ± 0.46) and the normalization of clinical and laboratory parameters after treatment was faster.

Keywords

• COPD
• disease exacerbation
• diagnosis
• treatment