BACTERIOLOGICAL STUDY OF ACUTE EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE
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Keywords
Acute exacerbations, Chronic Obstructive Pulmonary Disease, bacterial etiology, Antibiotic sensitivity.
Abstract
Background and objectives
Acute exacerbations are significant and frequent events in the natural history of Chronic Obstructive Pulmonary Disease (COPD). Majority of these exacerbations are of infectious etiology, bacteria are almost responsible for around 30-50% of cases. The purpose of this study was to determine the bacteriology of acute exacerbations of COPD in hospitalized patients in our institution and their antibiotic susceptibility pattern to formulate cost effective antibiotic strategy and reducing the emergence of drug resistance.
Methods
A prospective observational study was conducted among clinically diagnosed cases of acute exacerbations of COPD admitted in Medicine and Chest and Tuberculosis ward in Trichy SRM Medical College Hospital and Research Centre, Trichy. Direct gram stain was done for all sputum samples. The suitable sputum samples were cultured. Identification of organism and antimicrobial susceptibility testing was done by standard microbiological techniques.
Results
Significant growth of bacteria was obtained from 40.7% of sputum samples. Males (91.4%) were more affected than females (8.5%). The most common isolate was Klebsiella pneumoniae (39%), followed by Pseudomonas aeruginosa (29.7%), Acinetobacter baumanii (10.63%), E. coli (8.51%) and Staphylococcus aureus (7.8%). Drug sensitivity revealed that Gram negative isolates were sensitive to Levofloxacin (80.7%) followed by Amikacin (77.6%), Aztreonam (74.6%), Gentamicin (70.7%), Imipenem (68.4%) and Piperacillin-Tazobactam (66.9%).
Conclusion
Acute exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD) cases were common in males more than 50 years of age mainly due to smoking habits. Gram negative bacteria were more frequently isolated in our patients and appropriate antimicrobial therapy should be started early depending on the antimicrobial sensitivity results, in the wake of an increasing drug resistance.
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Dr. Selvi I.
Assistant Professor, Department of Microbiology, SUT Academy of Medical Sciences, Vattappara, Thiruvananthapuram, Kerala
Dr. Uma A.
Professor & HOD, Department of Microbiology, Trichy SRM Medical College Hospital and Research Centre, Trichy, Tamil Nadu, India.
Dr. Edwin D.
Assistant Professor, Department of Microbiology, Trichy SRM Medical College Hospital and Research Centre, Trichy, Tamil Nadu, India.