Clinico-bacteriological profile and antibiotic resistance pattern in patients with acute exacerbation of COPD

Abstract

Background Repeated attacks of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) have been attributed to bacterial infections. However, sputum microbiology for identifying the bacteriological profile is not performed usually and remains controversial. Thus, we performed a prospective, cross-sectional study to assess the clinico-bacteriological profile of the patients with AECOPD and antibiotic resistance pattern of bacteria isolated from sputum samples. The study involved 104 consecutive hospitalized patients, of either gender, aged 40–90 years, and diagnosed with AECOPD. Before initiating an empirical antibiotic therapy, the sputum samples of all the patients were collected and subjected to Gram staining, bacterial culture, and antibiotic sensitivity. Results The most common bacterial isolates were P. aeruginosa (30.7%) followed by K. pneumoniae (20.3%) and S. pneumoniae (8.6%). Both Gram-positive and Gram-negative bacteria were most sensitive to Meropenem (91%) followed by Amoxicillin-clavulanic acid (83%). However, these bacteria were most resistant to Cefoperazone-sulbactam (43%) followed by Levofloxacin (41%). P. aeruginosa and K. pneumoniae were most resistant to Cefoperazone-sulbactam (23%) followed by Fluoroquinolones (23–35%), while S. pneumoniae was most resistant to Ciprofloxacin (44%) followed by Amoxicillin-clavulanic acid (33%). Conclusions Isolation of P. aeruginosa, as the most common agent, further confirms its roles in severe attacks of AECOPD. The regularly used antibiotics were found to be resistant to most isolates, thereby suggesting that severity of AECOPD may be attributed to the prevalence of antibiotic-resistant strains.

Spectrum and antimicrobial resistance in acute exacerbation of chronic obstructive pulmonary disease with pneumonia: a cross-sectional prospective study from Vietnam

“…However, these findings differ significantly from those in Hong Kong [ 33 ] and Western countries such as the UK [ 32 ], where community-acquired pneumonia (CAP) ( H. influenzae, S. pneumoniae, and M. catarrhalis ) was associated with AE-COPD. Interestingly, these outcomes are contrary to those of Mood et al in India [ 35 ] and Mussema et al in Ethiopia [ 36 ]. These authors found that the most common bacterial isolate was P. aeruginosa , followed by K. pneumoniae and either S. pneumoniae or S. aureus .…”

Spectrum and antimicrobial resistance in acute exacerbation of chronic obstructive pulmonary disease with pneumonia among Vietnamese patients: A cross-sectional prospective study

“…However, these ndings differ signi cantly from those in Hong Kong [27] and Western countries such as the UK [26], where community-acquired pneumonia (CAP) (H. in uenzae, S. pneumoniae, and M. catarrhalis) was associated with AE-COPD. Interestingly, these outcomes are contrary to those of Mood et al in India [29] and Mussema et al in Ethiopia [30]. The authors found that the most common bacterial isolate was P. aeruginosa, followed by K. pneumoniae and either S. pneumoniae or S. aureus.…”

Pathogens Isolated and Their Association With the Long-Term Outcome in Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease

“…In a recent study conducted at the All India Institute of Medical Sciences (AIIMS), Bhubaneswar, the mean age was 65.49 ± 10.40 years [ 7 ]. As per another Indian study by Mood et al, the mean age of patients was 66.8 ± 11.4 years and the maximum prevalence was observed in the age group 70-79 years [ 8 ]. In another study that involved both European and American subjects, the proportion of females was 36.7% among Europeans and 33.3% among Americans, which is in accordance with our findings [ 9 ].…”

“…A study by Hajare et al reported a male-to-female ratio of 2.3:1 [ 10 ]. The preponderance of males being affected can be attributed to the fact that males are more involved in outdoor activities and hence are more exposed to environmental pollutants [ 8 ]. Smoking is a risk factor for COPD and also its exacerbation as it decreases mucociliary clearance, which is amply proved in our study where smoking as a risk factor was noticed among 64% of patients [ 11 ].…”

“…In the study by Jahan et al, the most common bacteria isolated were Pseudomonas aeruginosa (28%), followed by Acinetobacter baumannii and Klebsiella pneumoniae in seven cases each (21%) [ 7 ]. In another study, the most common bacterial isolates were P. aeruginosa (30.7%) followed by K. pneumoniae (20.3%) and S. pneumoniae (8.6%) [ 8 ].…”