ABSTRACT
Acute exacerbations of COPD is characterized by a change in the patients baseline dyspnoea, cough and/or sputum that is beyond normal day to day differences and guides to a change in standard medications in a patient with COPD. Vitamin D influences the innate & adaptive immune system, and exerts pleiotropic antimicrobial and anti-inflammatory responses. Vitamin D deficiency is frequent among COPD patients but its contributory role in disease exacerbations is widely debated. This study was aimed to assess relationship between reduced serum vitamin D (25-OHD) level with COPD severity and acute exacerbation. This observational cross-sectional study was carried out in the department of Respiratory Medicine, NIDCH, Mohakhali, Dhaka, Bangladesh from October 2016 to September 2017. Consecutive 80 hospital admitted patients with acute exacerbation of chronic obstructive pulmonary disease diagnosed on the basis of clinical history & pulmonary function tests and 78 age & sex matched controls were investigated for serum vitamin D (25-OHD) level. Among the COPD patients, 37% had Vitamin D deficiency (<20ng/ml) and 28.75% had Vitamin D insufficiency (20-29ng/ml). Mean vitamin D (25-OHD) level of COPD patients (25.82±10.62ngm/ml) was found to be significantly lower than healthy controls (32.57±11.32ngm/ml). Vitamin D deficiency was found, by Pearson correlation test, to be significantly associated with severity of COPD. Multivariate analysis showed that age (in years), FEV1 (percent predicted), frequent exacerbators (≥2 in the last year), and smoking (>40 pack year) were significantly associated with Vitamin D deficiency. Acute exacerbation of chronic obstructive pulmonary disease patients was found to have vitamin D deficiency and vitamin D deficiency was significantly associated with severity of COPD. Vitamin D deficiency was also associated with frequent disease exacerbation.
Subject(s)
Lung/physiopathology , Pulmonary Disease, Chronic Obstructive/complications , Vitamin D Deficiency/complications , Vitamin D/blood , Adult , Bangladesh/epidemiology , Biomarkers/blood , Case-Control Studies , Cross-Sectional Studies , Disease Progression , Forced Expiratory Volume , Humans , Middle Aged , Pulmonary Disease, Chronic Obstructive/blood , Pulmonary Disease, Chronic Obstructive/physiopathology , Severity of Illness Index , Vitamin D Deficiency/blood , Vitamin D Deficiency/epidemiology , Young AdultABSTRACT
This study evaluated the role of periodontal pathogens in 50 hospitalized patients with hospital acquired pneumonia compared with 30 healthy controls. Specimens of oropharyngeal aspirate, dental plaque bronchoalveolar lavage and blood cultured 1 or more pathogens in around 80% of patients, predominatel Staphylococcus aureus, followed by coagulase-negative staphylococci, Streptococcus pneumoniae and Klebsiell pneumoniae. Antibiotic sensitivity patterns showed concordance of bacterial cultures from dental plaque an oropharyngeal cavity in 13 patients. C-reactive protein (CRP) levels were significantly higher in patients than ii controls and there was a significant correlation between serum and salivary CR1' levels. Dental plaque bioflln may promote oral and oronpharyngeal colonization of respiratory pathogens in hospitalized subiects.
Subject(s)
Cross Infection/complications , Periodontitis/complications , Pneumonia, Bacterial/etiology , Biofilms/growth & development , Case-Control Studies , Cross Infection/diagnosis , Cross Infection/epidemiology , Dental Plaque/microbiology , Egypt/epidemiology , Escherichia coli Infections/etiology , Female , Humans , Klebsiella Infections/etiology , Klebsiella pneumoniae , Male , Microbial Sensitivity Tests , Middle Aged , Periodontal Index , Periodontitis/diagnosis , Periodontitis/epidemiology , Pneumococcal Infections/etiology , Pneumonia, Bacterial/diagnosis , Pneumonia, Bacterial/epidemiology , Risk Factors , Severity of Illness Index , Staphylococcal Infections/etiologyABSTRACT
This study evaluated the role of periodontal pathogens in 50 hospitalized patients with hospital-acquired pneumonia compared with 30 healthy controls. Specimens of oropharyngeal aspirate, dental plaque, bronchoalveolar lavage and blood cultured 1 or more pathogens in around 80% of patients, predominately Staphylococcus aureus, followed by coagulase-negative staphylococci, Streptococcus pneumoniae and Klebsiella pneumoniae. Antibiotic sensitivity patterns showed concordance of bacterial cultures from dental plaque and oropharyngeal cavity in 13 patients. C-reactive protein [CRP] levels were significantly higher in patients than in controls and there was a significant correlation between serum and salivary CRP levels. Dental plaque biofilm may promote oral and oropharyngeal colonization of respiratory pathogens in hospitalized subjects
