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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El objetivo de este estudio ha sido conocer mediante el empleo de una t&#233;cnica de alta Habilidad c&#243;mo es el cat&#233;ter teleescopado con cepillado bacteriol&#243;gico &#40;CT&#41;&#44; la presencia de g&#233;rmenes y su concentraci&#243;n en un grupo de pacientes con EPOC severa &#40;FEV<span class="elsevierStyleInf">1</span> &#60; 50&#37;&#41;&#44; unos en fase de estabilizaci&#243;n cl&#237;nica y otros con datos cl&#237;nicos de agudizaci&#243;n&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 26 pacientes con EPOC severa&#44; 14 estables y 12 agudizados&#46; Ninguno hab&#237;a recibido tratamiento previo con antibi&#243;ticos o corticoides&#46; Los estables no ten&#237;an ning&#250;n dato cl&#237;nico de exacerbaci&#243;n y los agudizados ten&#237;an aumento de disnea&#44; del volumen del esputo y de la purulencia del mismo&#46; El CT se realiz&#243; con anestesia en aerosol&#44; sin emplear anestesia l&#237;quida&#46; Se consider&#243; el CT positivo cuando hab&#237;a &#8805; 10<span class="elsevierStyleSup">3</span> UFC&#47;ml&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">No hubo diferencias entre los grupos en cuanto a edad&#44; sexo&#44; proporci&#243;n de fumadores y ex fumadores&#44; y paquetes&#47; a&#241;o&#46; En los valores espirom&#233;tricos tampoco hubo diferencias salvo en la relaci&#243;n FEV<span class="elsevierStyleInf">1</span>&#47;CVF que fue menor en los agudizados &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; El CT fue positivo en el 57&#44;1&#37; de los estables y en el 66&#44;7&#37; de los agudizados &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>NS&#41;&#46; H&#46; influenwe fue el microorganismo hallado en mayor n&#250;mero en ambos grupos&#46; El n&#250;mero medio de UFC&#47;ml fue de 8&#46;625 en los estables y 17&#46;375 en los agudizados &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>NS&#41;&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Un elevado n&#250;mero de pacientes &#40;57&#44;1&#37;&#41; con EPOC severa en fase de estabilizaci&#243;n cl&#237;nica presentaron g&#233;rmenes en concentraciones significativas mediante el empleo de CT&#46; Por otro lado&#44; con esta misma t&#233;cnica&#44; en otro grupo de pacientes con EPOC severa&#44; de similares caracter&#237;sticas&#44; pero con datos cl&#237;nicos de agudizaci&#243;n&#44; se hallaron g&#233;rmenes en el 66&#44;7&#37; no siendo la diferencia significativa&#44; y se confirm&#243; la falta de correlaci&#243;n cl&#237;nico-bacteriol&#243;gica&#46;</p></span>"
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Vol. 33. Issue 1.
Pages 16-19 (January 1997)
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Vol. 33. Issue 1.
Pages 16-19 (January 1997)
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El cepillado protegido bacteriológico en pacientes con EPOC severa
The protected specimen brush technique in patients with severe chronic obstructive pulmonary disease
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3787
R. Zalacain1, V. Achótegui, I. Pascal, J. Camino, V. Sobradillo
Servicios de Neumología, Hospital de Cruces. Vizcaya
J. Barrón*
* Servicios de Microbiología. Hospital de Cruces. Vizcaya
This item has received
Article information

El objetivo de este estudio ha sido conocer mediante el empleo de una técnica de alta Habilidad cómo es el catéter teleescopado con cepillado bacteriológico (CT), la presencia de gérmenes y su concentración en un grupo de pacientes con EPOC severa (FEV1 < 50%), unos en fase de estabilización clínica y otros con datos clínicos de agudización.

Se incluyeron 26 pacientes con EPOC severa, 14 estables y 12 agudizados. Ninguno había recibido tratamiento previo con antibióticos o corticoides. Los estables no tenían ningún dato clínico de exacerbación y los agudizados tenían aumento de disnea, del volumen del esputo y de la purulencia del mismo. El CT se realizó con anestesia en aerosol, sin emplear anestesia líquida. Se consideró el CT positivo cuando había ≥ 103 UFC/ml.

No hubo diferencias entre los grupos en cuanto a edad, sexo, proporción de fumadores y ex fumadores, y paquetes/ año. En los valores espirométricos tampoco hubo diferencias salvo en la relación FEV1/CVF que fue menor en los agudizados (p<0,05). El CT fue positivo en el 57,1% de los estables y en el 66,7% de los agudizados (p=NS). H. influenwe fue el microorganismo hallado en mayor número en ambos grupos. El número medio de UFC/ml fue de 8.625 en los estables y 17.375 en los agudizados (p=NS).

Un elevado número de pacientes (57,1%) con EPOC severa en fase de estabilización clínica presentaron gérmenes en concentraciones significativas mediante el empleo de CT. Por otro lado, con esta misma técnica, en otro grupo de pacientes con EPOC severa, de similares características, pero con datos clínicos de agudización, se hallaron gérmenes en el 66,7% no siendo la diferencia significativa, y se confirmó la falta de correlación clínico-bacteriológica.

Palabras clave:
Enfermedad pulmonar obstructiva crónica (EPOC)
Cepillado protegido

To determine the presence of germs and their concentratfon in a group of patients with severe chronic obstructive pulmonary disease (COPD) (FEV1 < 50%), some of whom were in stable condition and others of whom were in acute phase.

Twenty-six patients with severe COPD (14 stable and 12 acute phase) were enrolled. None had received prior antibiotic or corticoid treatment. The stable patients had no signs or symptoms of exacerbation, whereas the acute-phase patients had increased dyspnea, sputum volume and purulence. The patients received aerosol rather than liquid anesthesia when PSB sampling was performed. A PSB fínding was considered positive at a level ≥ 103CFU/ml.

There were no significant differences between the groups with respect to age, sex, proportion of smokers and ex-smokers or packs per year. The oniy spirometric measure that was significantly different was (FEV1/FVC, which was lower in the acute-phase group (p<0.05). Positive PSB findings were recorded for 57.1% of the stable patients and for 66.7% of the acute-phase patients (p=NS). H.influenzae was the microorganism found most often in both groups. The mean CFU/ml level was 8,625 in stable patients and 17,375 in acute-phase patients (p=NS).

A large proportion of stable patients (57.1%) with severe COPD harbor significant concentrations of germs as revealed by PSB sampling. Germ concentrations were found in a non significantly greater number of acute-phase patients, confirming the lack of congruence between clinical status and bacteriological condition.

Key words:
Chronic obstructive pulmonary disease (COPD)
Protected specimen brush
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Copyright © 1997. Sociedad Española de Neumología y Cirugía Torácica
Archivos de Bronconeumología
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