Sputum Culture and Antibiogram in Infective Acute Exacerbation of Chronic Obstructive Pulmonary Disease in a Tertiary Care Hospital in India

Abstract

Background. Infections are the common cause of death in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods.A prospective cohort study was conducted on 100 patients with AECOPD in a tertiary care hospital in Hyderabad city in South India. Sputum culture of 100 patients was evaluated for the presence of Gram-positive and Gram-negative micro-organisms. Sensitivity and resistance patterns of the micro-organisms against commonly used antibiotics were also investigated. Results.During the period October 2015 to April 2016, 67% of the patients had sputum culture positive for the presence of pathogenic micro-organisms. Pathogens, most commonly, isolated were Gram-negative organisms like Klebsiella oxytoca (13%), followed by Klebsiella species (11%) and Klebsiella pneumoniae (10%). Amikacin was found to be the most effective antibiotic against all micro-organisms. A significantly higher proportion of organisms were pathogenic compared to non-pathogenic organisms (p=0.0014). Among pathogenic organisms, a significantly higher proportion of Gram-positive organisms were found compared to Gram-negative organisms (p=0.0180). Pathogenic microorganisms showed a high resistance rate to commonly used antibiotics. Except few strains of Klebsiella, Pseudomonas and Streptococcus, overall 62.9% strains were sensitive to doxycycline. Conclusions.Our observations suggest that doxycycline can be used as an empirical antibiotic in the treatment of AECOPD.