Different expression about induced sputum cell sorting in the two main types of chronic obstructive pulmonary disease.

BACKGROUND: The difference in expression of sputum cells types between the two main types of chronic obstructive pulmonary disease (COPD) is largely unknown. This study aims to investigate the difference and then wants to depend on sputum cells sorting to direct the treatment of COPD. METHODS: A total of 218 patients with stable COPD (FEV1 < 80%) were selected. Stable COPD patients (n = 218) were classified as eosinophilic (A phenotype) or noneosinophilic (B phenotype); sometimes, the subjects were separated into cough group (C phenotype) and dyspnea group (D phenotype). Cross-sectional analysis was conducted comparing demographics and clinical characteristics. Receiver-operating characteristic curve was used to assess predictive ability of sputum eosinophils for D phenotype. RESULTS: The A phenotype showed a higher correlation with the patients complaining of presenting with dyspnea on exertion, the dyspnea group (D phenotype). The B phenotype showed a higher prevalence of those who cough and product sputum, this was cough group (C phenotype). Sputum eosinophil and macrophages counts were significantly higher in patients with dyspnea (n = 95) compared to those with cough (P < .05), and neutrophils were significantly lower in patients with dyspnea (n = 95) compared to those with cough (P < .05). Percentage sputum eosinophil count was predictive of dyspnea (D phenotype) COPD with area under curve (AUC) of 0.831 (95% confidence interval (CI) 0.77-0.89; P ≤ .001). Neutrophils were also predictive of dyspnea (D phenotype) COPD with AUC of 0.276 (95% CI 0.204-0.347; P ≤ .001). CONCLUSION: These findings suggest that the morphological phenotypes of COPD show several clinical characteristics and different sputum cell sorting.

Characteristics of Extended-Spectrum ß-Lactamases-Producing Escherichia coli in Fecal Samples of Inpatients of Beijing Tongren Hospital.

We aimed to investigate the prevalence of extended-spectrum ß-lactamases (ESBL)-producing Escherichia coli in Beijing Tongren hospital and to identify a possible relation between colonization and infection. The clinical data on 650 inpatients between March 2012 and July 2012 were retrospectively reviewed. The prevalence of ESBL-producing E. coli among the inpatients was 25.7% (167/650), with the highest level (50.0%) in the rheumatology ward and the lowest (10.0%) in intensive care units. Hospital stay more than 2 years prior to infection, the use of antibiotics within 3 months of infection, and the use of glucocorticoids or immunosuppressive drugs were found to be significantly associated with carriage of ESBL-producing E. coli (P < 0.05). In total, 76 sequence types (STs) were revealed by multilocus sequence typing. ST38 (n = 12, 7.2%) was the most common ST, followed by ST10 (n = 10, 6.0%) and ST131 and ST167 (n = 9 and 5.4% each). Among the fecal carriers, only one patient had an active infection, which was caused by an ST38 strain. In conclusion, in Beijing Tongren hospital, the prevalence of ESBL-producing E. coli was not high. The risk factors of carriage of ESBL-producing E. coli are hospitalization and use of antibiotics, glucocorticoids, or immunosuppressive drugs. ST38, ST10, ST131, and ST167 are the prominent genotypes, but almost 50.0% of STs were scarcely distributed.