Bacterial etiology of exacerbations of non-cystic fibrosis bronchiectases in young patients

Natalya Rutenko, Serik A Baidurin, Abai Baygenzhin

2013

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DOI 10.1183/13993003/erj.42.suppl_57.4649
Data confidence 70 medium
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Abstract

Background: Patients with bronchiectasis (BE) need frequent courses of antibacterial therapy (ABt) which is appointed empirically. It promotes growth of resistance of microflora. Aim: To determine a range of microorganisms in young patients with non-SF BE in the period of exacerbation and detect bacterial resistance to ABt. Methods: 38 patients mean age 19,1 (3,8) years with non-CF BE exacerbations were examined. Potentially pathogenic microorganisms (PPMs) were identified in a sputum and bronchoalveolar lavage (BAL). The PPMs resistance to ABt was detected. Results: 7/38 (18,4%) of cases bacteriology showed no growth of microflora. Associations of microorganisms were more often found out in a sputum, than in BAL (37,6% vs 22,1%, p=0,04). Sputum was more often contaminated by nasopharyngeal microorganisms. Coincidence of a sputum and BAL results in 17/31 (54,8%) of cases was revealed. In these cases M.catarrhalis (Mc) and S.pneumonia (Sp) showing loads over a 106 sfu/ml were identified more often (4/17 and 5/17). H.influenza (Hi) was isolated in 3/17. Exacerbations on extended BE were associated with P. cepacia in 2/17, P. aeruginosa in 1/17 that was reflected in severity of clinical symptoms. The highest resistance of Sp and Mc is revealed to macrolides (10-36%) mainly to erythromycin (36%) and azitromycin (19%). Resistance to amoxicillin was lower (7,5-12%). Conclusions: These findings show that in some cases the result of microbiological tests of sputum should be confirmed with BAL analysis. It will provide more objective results of bacteriology. In treatment of exacerbations of bronchiectasis it is necessary to consider high resistance to macrolids.