Abstract
Background
Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is responsible for a high proportion of morbidity and antibiotic use. This study aimed to identify the causative bacteria, antimicrobial sensitivity, and resistance of hospitalized patients in respiratory ICU owing to AECOPD.
Patients and methods
This prospective study was performed at Assiut University Hospitals on 50 patients with AECOPD who needed ICU admission. Samples included sputum for staining and culture. Samples were cultured on two bacteriological media (blood and MacConkey’s agars) to detect gram-positive and gram-negative organisms and their sensitivity to different antibiotics.
Results
Klebsiella pneumoniae was the most frequently detected organism in 29 (58%) patients followed by Pseudomonas aeruginosa in 14 (28%) patients, methicillin resistant Staphylococcus aureus (MRSA) in eight (16%) patients, Acinetobacter baumannii in seven (14%) patients, Proteus spp. and Staphylococcus aureus in five (10%) patients each, and Escherichia coli in three (6%) patients. No growth was reported in three (6%) patients. Among gram-positive organisms, linezolid had the upper hand of efficacy followed by vancomycin and teicoplanin. Gram-negative organisms had high rate or resistance to most tested antibiotics. Frequency of death was more (62.5%) in patients with MRSA.
Conclusion
K. pneumoniae was the most frequent organism followed by P. aeruginosa, MRSA, and A. baumannii. The isolated bacterial strains were characterized by high resistance rates to the most used antimicrobials. Mortality rate was more among patients with MRSA.
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References
Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management and prevention of chronic obstructive lung disease. 2016. Available at:www.goldcopd.org
Wedzicha JA, Seemungal TA. COPD exacerbations:defining their cause and prevention. Lancet 2007; 370:786–796.
World Health Organization. Chronic respiratory diseases, burden of chronic obstructive pulmonary disease 2015.
Sethi S, Murphy TF. Bacterial infection in chronic obstructive pulmonary disease in 2000:a state-of-the-art review. Clin Microbiol Rev 2001; 14:336–363.
Murray E, Baron J, Pfaller M, Tenover F, Yolken R. Manual of clinical microbiology 7th ed. Washington:American Society for Microbiology; 1999.
Shahnawaz A, Saleem SM, Bhat MA, Bhat G, Dhobi GN. Bacteriological profile in acute exacerbation of chronic obstructive pulmonary disease (COPD). JK Practitioner 2003; 10:185–187
Connors AFJr, Dawson NV, Thomas C, Harrell FEJr, Desbiens N, Fulkerson WJ, et al. Outcomes following acute exacerbation of severe chronic obstructive lung disease. The SUPPORT investigators (Study to understand prognoses and preferences for outcomes and risks of treatments). Am J Respir Crit Care Med 1996; 154:959–967.
Groenewegen KH, Schols AM, Wouters EF. mortality and mortality-related factors after hospitalization for acute exacerbation of COPD. Chest 2003; 124:459–467.
Soler-Cataluña JJ, Martínez-García MA, Sánchez LS, Tordera MP, Sánchez PR. Severe exacerbations and BODE index:two independent risk factors fordeath in male COPD patients. Respir Med 2009; 103:692–699.
Patel AK, Luhadia AS, Luhadia SK. Sputum bacteriology and antibiotic sensitivity pattern of patients having acute exacerbation of COPD in India – a preliminary study. J Pulm Respir Med 2015; 5:238.
Aleemullah MF, Krishnamurthy V, Harish M, ArshadAkeel C. Bacteriological profile of patients with AECOPD hospital based study. Int J Curr Microbiol Appl Sci 2016; 5:84–90.
Chawla K, Mukhopadhay C, Majumdar M, Bairy I. Bacteriological profile and their antibiogram from cases of acute exacerbations of chronic obstructive pulmonary disease:a hospital based study. J Clin Diagn Res 2008; 2:612–616.
Madhavi S, Ramarao MV, Janardhanrao R. Bacterial etiology of acute exacerbations of chronic obstructive pulmonary disease. J Microbiol Biotechnol Res 2012; 2:440–444.
Groenewegen KH, Wouters EF. Bacterial infections in patients requiring admission for an acute exacerbation of COPD; a 1-year prospective study. Respir Med 2003; 97:770–777.
Lin SH, Kuo PH, Hsueh PR, Yang PC, Kuo SH. Sputum bacteriology in hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease in Taiwan with an emphasis on Klebsiella pneumonia and Pseudomonas aeruginosa. Respirology 2007; 12:81–87.
Chakraborty A, Choudhury A, Debnath J, Saha N. Bacteriological profile and antibiotic sensitivity pattern in acute exacerbation of advanced cases of chronic obstructive pulmonary disease (COPD). JEBMH 2016; 3120–3122.
Agmy G, Mohamed S, Gad Y, Farghally E, Mohammedin H, Rashed H. Bacterial profile, antibiotic sensitivity and resistance of lower respiratory tract infections in Upper Egypt. Medite rr J Hematol Infect Dis 2013; 5: e2013056.
Hassan AT, Sherif MA, Mohamed MSE, El-Mokhtar AM. Acute exacerbations of chronic obstructive pulmonary disease:etiological bacterial pathogens and antibiotic resistance in Upper Egypt Year. Eypt J Bronchol 2016 10:283–290.
Fagon JY, Chastre J, Trouillet JL, Domart Y, Dombret MC, Bornet M, Gibert C. Characterization of distal bronchial microflora during acute exacerbation of chronic bronchitis. Use of the protected specimen brush technique in 54 mechanically ventilated patients. Am Rev Respir Dis 1990; 142:1004–1008.
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Ghanem, M.K., Makhlouf, H.A., Hasan, A.A. et al. Bacteriological profile of critically ill patients with chronic obstructive pulmonary disease in respiratory intensive care unit in Assuit University Hospital. Egypt J Bronchol 13, 343–348 (2019). https://doi.org/10.4103/ejb.ejb_83_18
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DOI: https://doi.org/10.4103/ejb.ejb_83_18