Prediction of Tracheobronchial Colonization in Current Cigarette Smokers with Chronic Obstructive Bronchitis

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Abstract
To help in clarifying the conflicting data on the role of tracheobronchial micro flora in chronic bronchitis, the tracheobronchial micro flora of a homogeneous group of clinically stable patients with chronic obstructive bronchitis was characterized by transtracheal aspiration. Their mean percentage ratio of forced expiratory volume in 1 sec to the forced vital capacity was 45%. The results were that (1) a bacterial tracheobronchial micro flora was present in only 50% of the patients, (2) viridans streptococci were the bacteria most frequently isolated, and (3) the presence or absence of a tracheobronchial micro flora was significantly associated with the amount of present cigarette smoking. The fact that patients who smoked less than one pack per day were most likely to have a sterile tracheobronchial tree (P = 0.015) implied that there was a critical amount of cigarette smoke that impaired the clearance and/or detoxification of bacteria from the tracheobronchial tree and that it must have been persistently present.