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  • Bronchial Colonization in P...
    Stojanovic, Ana

    Acta Facultatis Medicae Naissensis, 6/2015, Letnik: 32, Številka: 2
    Journal Article

    Lower airways are sterile, but many researchers have reported the existence of bronchial colonization with pathogenic and non-pathogenic microorganisms in smokers and patients with chronic obstructive pulmonary disease (COPD) and lung cancer. The aim of this study was to determine the existence and type of bronchial colonization in patients with non-small cell lung cancer (NSCLC), as well as to determine whether colonization depends on patient's age, smoking habit, pulmonary function and body mass index (BMI). Another aim was to estimate whether colonization causes early postoperative complications. Fifty-five subjects with pathohistologically confirmed non-small cell lung cancer in the resectable stage and good performance status (ECOG 0 or 1) participated in this cross-sectional study. We assessed patient's degree of smoking, calculated their BMI and determined the existence and severity of chronic obstructive pulmonary disease if there was one. The patients underwent a flexible bronchoscopy when biopsy samples were taken with protected specimen brush (PSB) and bronchoalveolar lavage (BAL); the retrieved samples were inoculated. Colonization was marked by an increase in the number of bacteria, yielding >10³CFU⁄L. In our study, bronchial colonization was found in 21 patients (38%). Potentially pathogenic microorganisms were isolated in 13 patients (Streptococcus pneumonia was found in five patients, Streptococcus B haemoliticus and Pseudononans in three patients each, Haemophilus influencae and Enterobacter in one patient each). Potentially non-pathogenic microorganisms were isolated in 8 patients (Streptococcus viridans was found in 7 patients and Achromobacter xylosoxidans in 1 patient). Patients' sex, age, smoking habit, body mass index and severity of chronic obstructive pulmonary disease were not statistically significant for developing bronchial colonization. Only one operated patient developed postoperative pneumonia, but he had not previously been diagnosed with bronchial colonization Donji disajni putevi su sterilni, ali mnogi istraživači potvrđuju postojanje kolonizacije bronha patogenim i nepatogenim mikroorganizmima kod pušača i obolelih od hronične opstrukcijske bolesti pluća i karcinoma pluća. Cilj ove studije bio je da utvrdi postojanje i vrstu kolonizacije bronhijalnog stabla kod obolelih od nesitnoćelijskog karcinoma pluća (NSCLC). Utvrditi da li godine života, pušenje, disajna funkcija i indeks telesne mase (body mass index, BMI) obolelih utiču na postojanje kolonizacije. Takođe, proceniti da li kolonizacija utiče na pojavu ranih postoperativnih komplikacija lečenja. Ova studija preseka obuhvatila je 55 ispitanika sa patohistološki potvrđenim nesitnoćelijskim karcinom pluća u resektabilnoj fazi bolesti i dobrim performans statusom (ECOG 0 ili 1). Procenjivali smo težinu pušačke navike, izračunavali BMI i određivali postojanje i stepen težine eventualno pridružene hronične opstrukcijske bolesti pluća. Pri fleksibilnoj bronhoskopiji uziman je uzorak biopsije zaštićenom četkicom, kao i bronhoalveolarni lavat i materijal je zasejavan na hranljivim podlogama. Kolonizaciju je označavao porast bakterija veći od 10³CFU⁄L. U našoj studiji, kolonizacija bronhalnog stabla bila je prisutna kod 21 bolesnika (38%). Potencijalno patogene mikroorganizme izolovali smo kod 13 bolesnika (Streptococcus pneumoniae kod 5, Streptococcus B haemoliticus kod tri i Pseudononas kod tri bolesnika, Haemophilus influencae kod jednog bolesnika i Enterobacter kod jednog bolesnika). Potencijalno nepatogene mikroorganizme izolovali smo kod 8 bolesnika (Streptococcus viridans kod 7, Achromobacter xylosoxidans kod jednog bolesnika). Pol, starost, pušenje, indeks telesne mase, kao ni težina ispoljene hronične opstrukcijske bolesti pluća, nisu statistički značajno uticali na pojavu kolonizacije bronhijalnog stabla. Samo je jedan operisani imao postoperativno pneumoniju, ali kod njega prethodno nije utvrđena kolonizacija bronhijalnog stabla