Bacterial Flora in Sputum and Antibiotic Sensitivity in Exacerbations of Bronchiectasis

Abstract

Background: The present study aimed to identify Bacterial Flora in Sputum during exacerbations of Bronchiectasis and to assess the antibiotic sensitivity pattern of isolated organisms. Materials and Methods: A Cross-sectional observational study was done in the Pulmonary Medicine ward of a tertiary care teaching hospital in Kerala for a period of one year. Sputum samples from 52 patients with exacerbation of bronchiectasis were subjected to bacterial culture and antibiotic sensitivity. Results: This study yielded pathogenic bacterial growth in 76.9 % samples. Gram negative organisms were predominant (87.5%). Three commonest organisms identified were Pseudomonas aeruginosa in 30.8% cases, Klebsiella in 21.2% cases and Acinetobacter in 9.6 % cases. Commonest gram positive bacteria were Streptococcus Pneumoniae (60%). Modified Ziehl-Neelsen stain for acid fast bacilli was negative in all cases. Pseudomonas aeruginosa was 100% sensitive to Imipenem (p value <0.05) and ciprofloxacin (p value <0.05).Sensitivity of pseudomonas aeruginosa to Piperacillin-tazobactam was 85.7% (p value <0.05). The sensitivity to commonly used antipseudomonal cephalosporin ceftazidime was only 42.8% (p value = 0.0265).60% cases of Acinetobacter group (p value <0.05) died during the hospital stay. Conclusion: The commonest organisms causing exacerbatioin of bronchiectasis in our study were gram negative organisms. The commonest isolate was Pseudomonas aeruginosa followed by Klebsiella. Initial empirical antibiotic therapy in severe bronchiectasis exacerbation canbe started with a combination of Piperacillin-tazobactam with Quinolones. Imipenem or Meropenem can be used as second line drugs.