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[Intractable respiratory infections]
K Nakata1, T Nakatani, Y Nakamori
1Department of Respiratory Medicine, Toranomon Hospital.
Abstract:
Silent aspiration would be major factor which predispose the bacterial infections in aged patients. Sixty-seven strains were isolated from culture positive cases. Anaerobes, S. pneumoniae, S. aureus, P. aeruginosa were the more frequently isolated strains of bacteria. Gram-negative rods were apparent in 39%, and Anaerobes were 19%, of 67 strains. Patients with diffuse panbronchiolitis are frequently affected by P. aeruginosa superinfection. The patients with longer duration, more severe lung function and more deteriorated roentgenological findings developed P. aeruginosa superinfection more easily. These infection in the lower respiratory tract significantly affect the prognosis of DPB patients. Using long-term administration of erythromycin against DPB, acute exacerbation were controlled in some patients and the frequency of their admission to hospital was lessened.
Insights
Silent aspiration frequently leads to bacterial infections in elderly patients. Diffuse panbronchiolitis patients with severe disease are prone to Pseudomonas aeruginosa superinfection, impacting prognosis.
Area of Science:
- Microbiology
- Pulmonology
- Infectious Diseases
Context:
- Silent aspiration is a significant risk factor for bacterial infections in the elderly.
- Bacterial infections, particularly superinfections, complicate the course of diffuse panbronchiolitis (DPB).
- Pseudomonas aeruginosa superinfection is more common in DPB patients with prolonged disease, severe lung dysfunction, and advanced radiological findings.
Purpose:
- To identify common bacterial pathogens associated with infections in elderly patients.
- To investigate the factors predisposing to Pseudomonas aeruginosa superinfection in diffuse panbronchiolitis.
- To evaluate the efficacy of long-term erythromycin administration in managing DPB exacerbations.
Summary:
- Sixty-seven bacterial strains were isolated from infected elderly patients, with anaerobes, Streptococcus pneumoniae, Staphylococcus aureus, and Pseudomonas aeruginosa being frequent isolates.
- Gram-negative rods constituted 39% and anaerobes 19% of the isolated strains.
- Long-term erythromycin therapy demonstrated potential in controlling acute exacerbations and reducing hospital admissions in DPB patients.
Impact:
- Understanding common pathogens aids in targeted antimicrobial therapy for elderly patients.
- Identifying risk factors for P. aeruginosa superinfection can guide preventive strategies in DPB.
- Erythromycin may offer a therapeutic benefit in managing DPB, improving patient outcomes and reducing healthcare utilization.