D1.398 - Retrospective study of the effect of bacterial immunotheraphy on patients with chronic respiratory diseases
Background
Bacterial autovaccines are inactivated bacterial suspensions made from one or more bacterial strains obtained from the culture of a sample taken from the patient. They are then administered to develop an acquired immune response.Bacterial immunotherapy (BI) is indicated in recurrent bacterial infections. Good results have been described in otorhinolaryngological and urinary infections. In bronchopulmonary infections, experience is more limited. We studied retrosprectively the effect of BI in chronic respiratory patients.
Method
We studied 53 patients treated with BI over a 12-month period (2023-2024). The samples were taken in the Pneumology office, by swab and at oropharyngeal level. The number of infections before and after BI was reviewed, as well as the number of hospital admissions for lower respiratory tract infections.
Results
53 patients (32 men) with a mean age of 72.8±10.3 and BMI of 29.8±6.36. Smokers 16 (30.2%), former smokers 25 (47.2%). 38 patients had COPD: mild grade 6 (15.4%), moderate (38.5%), severe (46.2%). 61 patients (30.8%) were asthmatic and 13 (24.5%) had bronchiectasis.Bacteria detected: S. pneumoniae 48 (90.6%), S. aureus 15 (28.3%), Klebsiella 12 (22.6%), P aeruginosa 10 (18.9%), Enterobacter 6 (11.3%), Acinetobacter iwoffi 3 (5.7%) and Serratia 1 (1.9%). 42 patients (79.2%) combined two of these germs in their vaccines. Hospital admissions for infectious causes before (17 patients; 32.1%) and after BI (4 patients; 7.5%). Exacerbations (≤1 vs ≥2): ≤1 before IB 20 patients (37.7%)// after 48 (90.6%). ≥2 before IB 33 patients (62.3%), after 5 (9.4%). Before IB with zero exacerbations 7 patients (13.2%), after IB 36 (67.9%), indicating a 54.7% increase of patients without exacerbations.The results are shown in the table.
| Before IB | After IB | Differences | |
|
Exacerbations 0 1 2 3 4 |
7 (13.2%) 13 (24.5%) 20(37.7%) 12(22.6%) 1(1.9%) |
36 (67.9%) 12 (22.6%) 5 (9.4%) 0 0 |
p<0.06 |
|
Exacerbations ≤1 ≥2 |
20 (37.7%) 33 (62.3%) |
48 (90.6%) 5 (9.4%) |
|
| Admittances | 17 (32.1%) | 4 (7.5%) | ↘24.6% |
Conclusion
Due to the low number of patients in our study, statistical significance has not been reached (p<0.06) although there is an evident tendency, since the number of exacerbations and admissions have clearly decreased. It is noteworthy that the percentage of patients without new infections after autovaccines increased by 54%. It seems to us that bacterial lysates, through stimulation of the immune system can be an effective therapeutic tool for prevention respiratory infections.
