Type of publication:
Conference abstract
Author(s):
*Thumbe A.; *Ahmad N.
Citation:
Thorax. Conference: British Thoracic Society Winter Meeting 2025. Westminster . 80(Supplement 2) (pp A122), 2025. Date of Publication: 01 Nov 2025.
Abstract:
Background COPD is a heterogenous disease, and the eosinophilic phenotype is now well recognised as a treatable trait. However, it is less well known as to what extent bacterial infections affect this group of patients.1 Aim Our primary aim was to look at the incidence of bacterial growth in eosinophilic and the non-eosinophilic phenotype within our cohort of patients with COPD. Method A retrospective analysis was conducted on patients coded has having been admitted to our Trust with COPD exacerbations from October 2020 to April 2021. Historic sputum culture results were collected from our web-based patient portal. Patients were included in the analysis if they had a sputum culture showing bacterial growth at any time. Eosinophilic phenotypes (EP) were defined as having a blood eosinophil count >=0.3×109/L and non-eosinophilic phenotypes (NEP) as having a blood eosinophil count<0.3×109/L. Results In the study period, 337 unique patients were admitted with COPD exacerbations. They had a mean age (SD) of 73 (9) years, 49.6% (167/337) were female and 64.1% (216/337) were EP. 47% (n=157/337) patients had at least one positive sputum culture. Of these, 68.8% (n=108/157) were classified as EP. 72%(n=108/150) of EP had a positive sputum culture compared to 70% (n=49/70) of NEP; Odds Ratio 1.10 (95% CI 0.59-2.06); Chi-Square 0.021; p=0.88. When compared, NEP had higher burden of H. Influenzae, Strep Pneumoniae and Moraxella (59%, 20% and 20% vs 55%, 19% and 15%, respectively) whereas EP had a higher burden of Coliforms, Pseudomonas sp and S.aureus (32%, 30% and 15% v 25%, 25% and 8%, respectively). Conclusion Our findings suggest that in COPD patients requiring hospital admission, there is no significant difference between the bacterial burden of EP and NEP. Hence, future treatments of EP should not only include biologics but also focus on the role of bacteria in preventing exacerbations.
DOI: 10.1136/thorax-2025-BTSabstracts.179
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