{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T04:49:30Z","timestamp":1783745370955,"version":"3.55.0"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2018,6,15]],"date-time":"2018-06-15T00:00:00Z","timestamp":1529020800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Respir Res"],"published-print":{"date-parts":[[2018,12]]},"DOI":"10.1186\/s12931-018-0820-1","type":"journal-article","created":{"date-parts":[[2018,6,15]],"date-time":"2018-06-15T03:55:46Z","timestamp":1529034946000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Microorganisms resistant to conventional antimicrobials in acute exacerbations of chronic obstructive pulmonary disease"],"prefix":"10.1186","volume":"19","author":[{"given":"Cristina","family":"Estirado","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Ceccato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Guerrero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arturo","family":"Huerta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catia","family":"Cilloniz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia","family":"Vilar\u00f3","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Gabarr\u00fas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joaquim","family":"Gea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernesto","family":"Crisafulli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nestor","family":"Soler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoni","family":"Torres","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2018,6,15]]},"reference":[{"key":"820_CR1","doi-asserted-by":"publisher","first-page":"925","DOI":"10.1136\/thx.2005.040527","volume":"60","author":"JJ Soler-Catalu\u00f1a","year":"2005","unstructured":"Soler-Catalu\u00f1a JJ, Mart\u00ednez-Garc\u00eda MA, Rom\u00e1n S\u00e1nchez P, Salcedo E, Navarro M, Ochando R. Severe acute exacerbations and mortality in patients with chronic obstructive pulmonary disease. Thorax. 2005;60:925\u201331.","journal-title":"Thorax"},{"key":"820_CR2","doi-asserted-by":"publisher","first-page":"1498","DOI":"10.1164\/ajrccm.157.5.9711044","volume":"157","author":"N Soler","year":"1998","unstructured":"Soler N, Torres A, Ewig S, Gonzalez J, Celis R, El-Ebiary M, et al. Bronchial microbial patterns in severe exacerbations of chronic obstructive pulmonary disease (COPD) requiring mechanical ventilation. Am J Respir Crit Care Med. 1998;157:1498\u2013505.","journal-title":"Am J Respir Crit Care Med"},{"key":"820_CR3","doi-asserted-by":"publisher","first-page":"786","DOI":"10.1016\/S0140-6736(07)61382-8","volume":"370","author":"JA Wedzicha","year":"2007","unstructured":"Wedzicha JA, Seemungal TAR. COPD exacerbations: defining their cause and prevention. Lancet Lond Engl. 2007;370:786\u201396.","journal-title":"Lancet Lond Engl"},{"key":"820_CR4","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1136\/thorax.58.1.73","volume":"58","author":"AJ White","year":"2003","unstructured":"White AJ, Gompertz S, Stockley RA. Chronic obstructive pulmonary disease. 6: the aetiology of exacerbations of chronic obstructive pulmonary disease. Thorax. 2003;58:73\u201380.","journal-title":"Thorax"},{"key":"820_CR5","unstructured":"From the Global Strategy for the Diagnosis, Management and Prevention of COPD Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017. Available \n                    http:\/\/www.goldcopd.org\/\n                    \n                  . Accessed 1 Nov 2018."},{"key":"820_CR6","doi-asserted-by":"publisher","first-page":"1138","DOI":"10.1183\/09031936.05.00055705","volume":"26","author":"M Woodhead","year":"2005","unstructured":"Woodhead M, Blasi F, Ewig S, Huchon G, Leven M, Ortqvist A, et al. Guidelines for the management of adult lower respiratory tract infections. Eur Respir J. 2005;26:1138\u201380.","journal-title":"Eur Respir J"},{"key":"820_CR7","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1378\/chest.116.1.40","volume":"116","author":"M Miravitlles","year":"1999","unstructured":"Miravitlles M, Espinosa C, Fern\u00e1ndez-Laso E, Martos JA, Maldonado JA, Gallego M. Relationship between bacterial flora in sputum and functional impairment in patients with acute exacerbations of COPD. Study Group of Bacterial Infection in COPD. Chest. 1999;116:40\u20136.","journal-title":"Chest"},{"key":"820_CR8","doi-asserted-by":"publisher","first-page":"1542","DOI":"10.1378\/chest.113.6.1542","volume":"113","author":"J Eller","year":"1998","unstructured":"Eller J, Ede A, Schaberg T, Niederman MS, Mauch H, Lode H. Infective exacerbations of chronic bronchitis: relation between bacteriologic etiology and lung function. Chest. 1998;113:1542\u20138.","journal-title":"Chest"},{"key":"820_CR9","doi-asserted-by":"publisher","first-page":"1015","DOI":"10.1183\/09031936.99.14510159","volume":"14","author":"N Soler","year":"1999","unstructured":"Soler N, Ewig S, Torres A, Filella X, Gonzalez J, Zaubet A. Airway inflammation and bronchial microbial patterns in patients with stable chronic obstructive pulmonary disease. Eur Respir J. 1999;14:1015\u201322.","journal-title":"Eur Respir J"},{"key":"820_CR10","doi-asserted-by":"publisher","first-page":"891","DOI":"10.1001\/archinte.165.8.891","volume":"165","author":"A Rosell","year":"2005","unstructured":"Rosell A, Mons\u00f3 E, Soler N, Torres F, Angrill J, Riise G, et al. Microbiologic determinants of exacerbation in chronic obstructive pulmonary disease. Arch Intern Med. 2005;165:891\u20137.","journal-title":"Arch Intern Med"},{"key":"820_CR11","doi-asserted-by":"publisher","first-page":"1224","DOI":"10.1183\/09031936.00109906","volume":"29","author":"BR Celli","year":"2007","unstructured":"Celli BR, Barnes PJ. Exacerbations of chronic obstructive pulmonary disease. Eur Respir J. 2007;29:1224\u201338.","journal-title":"Eur Respir J"},{"key":"820_CR12","first-page":"141","volume":"19","author":"R Leclercq","year":"2013","unstructured":"Leclercq R, Cant\u00f3n R, Brown DFJ, Giske CG, Heisig P, MacGowan AP, et al. EUCAST expert rules in antimicrobial susceptibility testing. Clin Microbiol Infect Off Publ Eur Soc Clin Microbiol Infect Dis. 2013;19:141\u201360.","journal-title":"Clin Microbiol Infect Off Publ Eur Soc Clin Microbiol Infect Dis"},{"key":"820_CR13","first-page":"268","volume":"18","author":"A-P Magiorakos","year":"2012","unstructured":"Magiorakos A-P, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect Off Publ Eur Soc Clin Microbiol Infect Dis. 2012;18:268\u201381.","journal-title":"Clin Microbiol Infect Off Publ Eur Soc Clin Microbiol Infect Dis."},{"key":"820_CR14","first-page":"339","volume":"50","author":"PR Murray","year":"1975","unstructured":"Murray PR, Washington JA. Microscopic and baceriologic analysis of expectorated sputum. Mayo Clin Proc. 1975;50:339\u201344.","journal-title":"Mayo Clin Proc"},{"key":"820_CR15","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","volume":"40","author":"ME Charlson","year":"1987","unstructured":"Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373\u201383.","journal-title":"J Chronic Dis"},{"key":"820_CR16","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1183\/09031936.00087208","volume":"33","author":"M Miravitlles","year":"2009","unstructured":"Miravitlles M, Llor C, de Castellar R, Izquierdo I, Bar\u00f3 E, Donado E. Validation of the COPD severity score for use in primary care: the NEREA study. Eur Respir J. 2009;33:519\u201327.","journal-title":"Eur Respir J"},{"key":"820_CR17","doi-asserted-by":"publisher","first-page":"692","DOI":"10.1016\/j.rmed.2008.12.005","volume":"103","author":"JJ Soler-Catalu\u00f1a","year":"2009","unstructured":"Soler-Catalu\u00f1a JJ, Mart\u00ednez-Garc\u00eda MA, S\u00e1nchez LS, Tordera MP, S\u00e1nchez PR. Severe exacerbations and BODE index: two independent risk factors for death in male COPD patients. Respir Med. 2009;103:692\u20139.","journal-title":"Respir Med"},{"key":"820_CR18","unstructured":"Healey JF. Statistics: a tool for social research. 9th ed: Wadsworth: Cengage Learning; 2011."},{"key":"820_CR19","doi-asserted-by":"crossref","unstructured":"Efron B, Tibshirani RJ. An introduction to the bootstrap: CRC Press; 1994.","DOI":"10.1007\/978-1-4899-4541-9"},{"key":"820_CR20","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2393","volume":"338","author":"JAC Sterne","year":"2009","unstructured":"Sterne JAC, White IR, Carlin JB, Spratt M, Royston P, Kenward MG, et al. Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls. BMJ. 2009;338:b2393.","journal-title":"BMJ"},{"key":"820_CR21","doi-asserted-by":"publisher","DOI":"10.1007\/978-0-387-77244-8","volume-title":"Clinical prediction models: a practical Aapproach to development, validation, and updating","author":"E Steyerberg","year":"2009","unstructured":"Steyerberg E. Clinical prediction models: a practical Aapproach to development, validation, and updating. Springer: New York, 2009."},{"key":"820_CR22","doi-asserted-by":"publisher","first-page":"1128","DOI":"10.1056\/NEJMoa0909883","volume":"363","author":"JR Hurst","year":"2010","unstructured":"Hurst JR, Vestbo J, Anzueto A, Locantore N, M\u00fcllerova H, Tal-Singer R, et al. Susceptibility to exacerbation in chronic obstructive pulmonary disease. N Engl J Med. 2010;363:1128\u201338.","journal-title":"N Engl J Med"},{"key":"820_CR23","doi-asserted-by":"crossref","unstructured":"Cill\u00f3niz C, Gabarr\u00fas A, Ferrer M, Puig de la Bellacasa J, Rinaudo M, Mensa J, et al. Community-acquired pneumonia due to multidrug and non-multidrug resistant Pseudomonas aeruginosa. Chest 2016.","DOI":"10.1183\/13993003.congress-2016.PA608"},{"key":"820_CR24","first-page":"142","volume":"74","author":"L Fern\u00e1ndez-Barat","year":"2017","unstructured":"Fern\u00e1ndez-Barat L, Ferrer M, De Rosa F, Gabarr\u00fas A, Esperatti M, Terraneo S, et al. Intensive care unit-acquired pneumonia due to Pseudomonas aeruginosa with and without multidrug resistance. J Inf Secur. 2017;74:142\u201352.","journal-title":"J Inf Secur"},{"key":"820_CR25","doi-asserted-by":"publisher","first-page":"2072","DOI":"10.1378\/chest.127.6.2072","volume":"127","author":"I Brook","year":"2005","unstructured":"Brook I, Gober AE. Recovery of potential pathogens and interfering bacteria in the nasopharynx of smokers and nonsmokers. Chest. 2005;127:2072\u20135.","journal-title":"Chest"},{"key":"820_CR26","doi-asserted-by":"publisher","first-page":"1375","DOI":"10.1086\/508428","volume":"194","author":"CS Berenson","year":"2006","unstructured":"Berenson CS, Garlipp MA, Grove LJ, Maloney J, Sethi S. Impaired phagocytosis of nontypeable Haemophilus influenzae by human alveolar macrophages in chronic obstructive pulmonary disease. J Infect Dis. 2006;194:1375\u201384.","journal-title":"J Infect Dis"},{"key":"820_CR27","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1164\/rccm.200509-1461OC","volume":"174","author":"CS Berenson","year":"2006","unstructured":"Berenson CS, Wrona CT, Grove LJ, Maloney J, Garlipp MA, Wallace PK, et al. Impaired alveolar macrophage response to Haemophilus antigens in chronic obstructive lung disease. Am J Respir Crit Care Med. 2006;174:31\u201340.","journal-title":"Am J Respir Crit Care Med"},{"key":"820_CR28","doi-asserted-by":"publisher","first-page":"840","DOI":"10.1016\/j.rmed.2009.12.010","volume":"104","author":"F Renom","year":"2010","unstructured":"Renom F, Y\u00e1\u00f1ez A, Garau M, Rub\u00ed M, Centeno M-J, Gorriz M-T, et al. Prognosis of COPD patients requiring frequent hospitalization: role of airway infection. Respir Med. 2010;104:840\u20138.","journal-title":"Respir Med"},{"key":"820_CR29","doi-asserted-by":"publisher","first-page":"794","DOI":"10.1183\/09031936.00023414","volume":"44","author":"AK Boutou","year":"2014","unstructured":"Boutou AK, Raste Y, Reid J, Alshafi K, Polkey MI, Hopkinson NS. Does a single Pseudomonas aeruginosa isolation predict COPD mortality? Eur Respir J. 2014;44:794\u20137.","journal-title":"Eur Respir J"},{"key":"820_CR30","doi-asserted-by":"publisher","first-page":"1072","DOI":"10.1183\/09031936.00003309","volume":"34","author":"C Garcia-Vidal","year":"2009","unstructured":"Garcia-Vidal C, Almagro P, Roman\u00ed V, Rodr\u00edguez-Carballeira M, Cuchi E, Canales L, et al. Pseudomonas aeruginosa in patients hospitalised for COPD exacerbation: a prospective study. Eur Respir J. 2009;34:1072\u20138.","journal-title":"Eur Respir J"},{"key":"820_CR31","doi-asserted-by":"publisher","first-page":"1235","DOI":"10.1111\/resp.12825","volume":"21","author":"A Rodrigo-Troyano","year":"2016","unstructured":"Rodrigo-Troyano A, Suarez-Cuartin G, Peir\u00f3 M, Barril S, Castillo D, Sanchez-Reus F, et al. Pseudomonas aeruginosa resistance patterns and clinical outcomes in hospitalized exacerbations of COPD. Respirol Carlton Vic. 2016;21:1235\u201342.","journal-title":"Respirol Carlton Vic"},{"key":"820_CR32","first-page":"1602","volume":"12","author":"S Finch","year":"2015","unstructured":"Finch S, McDonnell MJ, Abo-Leyah H, Aliberti S, Chalmers JD. A comprehensive analysis of the impact of Pseudomonas aeruginosa colonization on prognosis in adult bronchiectasis. Ann Am Thorac Soc. 2015;12:1602\u201311.","journal-title":"Ann Am Thorac Soc"},{"key":"820_CR33","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1016\/j.rmed.2016.06.007","volume":"117","author":"R Wilson","year":"2016","unstructured":"Wilson R, Aksamit T, Aliberti S, De Soyza A, Elborn JS, Goeminne P, et al. Challenges in managing Pseudomonas aeruginosa in non-cystic fibrosis bronchiectasis. Respir Med. 2016;117:179\u201389.","journal-title":"Respir Med"},{"key":"820_CR34","doi-asserted-by":"publisher","first-page":"1754","DOI":"10.1183\/09031936.97.10081754","volume":"10","author":"CB Wilson","year":"1997","unstructured":"Wilson CB, Jones PW, O\u2019Leary CJ, Hansell DM, Cole PJ, Wilson R. Effect of sputum bacteriology on the quality of life of patients with bronchiectasis. Eur Respir J. 1997;10:1754\u201360.","journal-title":"Eur Respir J"},{"key":"820_CR35","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1016\/j.jpeds.2008.08.001","volume":"154","author":"SD Sagel","year":"2009","unstructured":"Sagel SD, Gibson RL, Emerson J, McNamara S, Burns JL, Wagener JS, et al. Impact of pseudomonas and staphylococcus infection on inflammation and clinical status in young children with cystic fibrosis. J Pediatr. 2009;154:183\u20138.","journal-title":"J Pediatr"},{"key":"820_CR36","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1002\/ppul.10127","volume":"34","author":"J Emerson","year":"2002","unstructured":"Emerson J, Rosenfeld M, McNamara S, Ramsey B, Gibson RL. Pseudomonas aeruginosa and other predictors of mortality and morbidity in young children with cystic fibrosis. Pediatr Pulmonol. 2002;34:91\u2013100.","journal-title":"Pediatr Pulmonol"},{"key":"820_CR37","volume":"12","author":"DJ Vollenweider","year":"2012","unstructured":"Vollenweider DJ, Jarrett H, Steurer-Stey CA, Garcia-Aymerich J, Puhan MA. Antibiotics for exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2012;12:CD010257.","journal-title":"Cochrane Database Syst Rev"},{"key":"820_CR38","doi-asserted-by":"publisher","first-page":"2020","DOI":"10.1016\/S0140-6736(01)07097-0","volume":"358","author":"S Nouira","year":"2001","unstructured":"Nouira S, Marghli S, Belghith M, Besbes L, Elatrous S, Abroug F. Once daily oral ofloxacin in chronic obstructive pulmonary disease exacerbation requiring mechanical ventilation: a randomised placebo-controlled trial. Lancet Lond Engl. 2001;358:2020\u20135.","journal-title":"Lancet Lond Engl."},{"key":"820_CR39","doi-asserted-by":"publisher","first-page":"957","DOI":"10.1001\/jama.1995.03520360071042","volume":"273","author":"S Saint","year":"1995","unstructured":"Saint S, Bent S, Vittinghoff E, Grady D. Antibiotics in chronic obstructive pulmonary disease exacerbations. A meta-analysis. JAMA. 1995;273:957\u201360.","journal-title":"JAMA"},{"key":"820_CR40","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1136\/thx.2005.045930","volume":"61","author":"R Wilson","year":"2006","unstructured":"Wilson R, Jones P, Schaberg T, Arvis P, Duprat-Lomon I, Sagnier PP, et al. Antibiotic treatment and factors influencing short and long term outcomes of acute exacerbations of chronic bronchitis. Thorax. 2006;61:337\u201342.","journal-title":"Thorax"},{"key":"820_CR41","doi-asserted-by":"publisher","first-page":"1344","DOI":"10.1183\/09031936.00150211","volume":"40","author":"N Soler","year":"2012","unstructured":"Soler N, Esperatti M, Ewig S, Huerta A, Agust\u00ed C, Torres A. Sputum purulence-guided antibiotic use in hospitalised patients with exacerbations of COPD. Eur Respir J. 2012;40:1344\u201353.","journal-title":"Eur Respir J"},{"key":"820_CR42","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1136\/thx.2005.056374","volume":"62","author":"N Soler","year":"2007","unstructured":"Soler N, Agust\u00ed C, Angrill J, Puig De la Bellacasa J, Torres A. Bronchoscopic validation of the significance of sputum purulence in severe exacerbations of chronic obstructive pulmonary disease. Thorax. 2007;62:29\u201335.","journal-title":"Thorax"}],"container-title":["Respiratory Research"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12931-018-0820-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12931-018-0820-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12931-018-0820-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,6,14]],"date-time":"2019-06-14T23:08:53Z","timestamp":1560553733000},"score":1,"resource":{"primary":{"URL":"https:\/\/respiratory-research.biomedcentral.com\/articles\/10.1186\/s12931-018-0820-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6,15]]},"references-count":42,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2018,12]]}},"alternative-id":["820"],"URL":"https:\/\/doi.org\/10.1186\/s12931-018-0820-1","relation":{},"ISSN":["1465-993X"],"issn-type":[{"value":"1465-993X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,6,15]]},"assertion":[{"value":"28 December 2017","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 May 2018","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 June 2018","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study protocol was approved by the Hospital Research and Ethics Committee (CEIC 2008\/4106) and the study was conducted in accordance with good clinical practice guidelines and the declaration of Helsinki. Written informed consent was obtained from all enrolled patients.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare that they have no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Publisher\u2019s Note"}}],"article-number":"119"}}