Effects of immunomodulatory bacterial extracts on exacerbations in chronic respiratory diseases

Introduction: 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. Methods: We studied 53 patients treated with BI over a 12-month period. 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. pneumonia 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 BI 20 patients (37.7%) // after 48 (90.6%).≥2 before BI 33 patients (62.3%), after 5 (9.4%). Before BI with zero exacerbations 7 patients (13.2%), after BI 36 (67.9%), indicating a 54.7% increase of patients without exacerbations.The results are shown in the [ Fig. 1 ]. Conclusions: Due to the low number of patients in our study, statistical significance has not been reached (p