Microbiology and radiology of pneumonia in COPD
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Lydia Finney1, Sarah Elkin2, Samuel Todd2, Vijay Padmanaban2 and Patrick Mallia1,2
Background: Pneumonia is associated with increased morbidity and mortality in COPD. We aimed to characterise the infectious aetiology and radiology of pneumonia in COPD and identify potential risk factors.
Methods: Retrospective analysis of medical records for patients with COPD (FEV1/FVC <0.70) admitted to 3 London hospitals between 01/01/2010 and 31/12/2012 with pneumonia or exacerbation (AECOPD). Patients were identified by COPD bundles. Admission CXRs were assessed by 2 independent observers. Pneumonia was defined as new consolidation on CXR.
Gram negative organisms were identified in 21% of pneumonias and 13% of exacerbations. The most commonly isolated organism was Pseudomonas aeruginosa (7% of pneumonia, 5% of AECOPD). 44% of pneumonias were lobar, 42% multifocal and 13% bibasal.
Conclusions: Incidence of pneumonia in COPD is likely to be underestimated. The most commonly isolated bacteria were gram negatives which may not respond to current antibiotic guidelines for community acquired pneumonia. Risk factors for pneumonia are previous history of pneumonia and age≥ 75 years.
PDPI Lampung & Bengkulu. 08/03/18.
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