Đặc điểm lâm sàng, cận lâm sàng và vi khuẩn ở bệnh nhân đợt cấp giãn phế quản nhập viện

Abstract

Objective: To describe the clinical and laboratory features, as well as the bacteriological characteristics in bronchoaveolar lavage fluid in hospitalized patients with acute exacerbation of bronchiectasis. Subject and method: A descriptive cross-sectional study was conducted involving 122 patients diagnosed with acute exacerbation of bronchiectasis. Among them, bronchoscopy was performed in 60 patients to collect bronchoaveolar lavage fluid for microbiological culture analysis. Additionally, sputum samples were collected, cultured, and compared with the results of bronchoaveolar lavage fluid cultures. Result: Male patients accounted for 51.6%, with an average age of 68.09 ± 10.86 years. Patients presented a notable prevalence of history of pulmonary tuberculosis and underlying comorbidities. Common symptoms included cough, sputum, dyspnea, and crackles upon lung examination. On average, patients experienced 1.88 ± 1.43 exacerbations per year requiring hospitalization. HRCT revealed diffuse dilatation involvement in 82.8% of cases. Patients with underlying diseases and diffuse lesion on HRCT had a significantly higher frequency of ≥ 2 exacerbations per year compared to those without comorbidities and local lesion on HRCT with p<0.05. Microbiological analysis demonstrated positive culture rates of 86.7% in bronchoaveolar lavage fluid samples and 96% in sputum samples. Gram-negative bacteria were isolated, with Pseudomonas aeruginosa, Escherichia coli, and Acinetobacter baumannii being the most frequently identified pathogens. There was no significant differences in bacteriological distribution between patients experiencing ≥ 2 exacerbations per year compared to those with fewer exacerbations. Conclusion: Patients experiencing acute exacerbations of bronchiectasis upon hospitalization commonly exhibit a history of pulmonary tuberculosis and a significant prevalence of underlying diseases, mainly with diffuse lesions, frequently require multiple hospitalizations per year. Gram-negative bacteria were most frequently identified pathogens, and still sensitive to several types of antibiotics.