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Sputum culture and antibiotic resistance in elderly inpatients with exacerbation of chronic obstructive pulmonary disease at a tertiary geriatric hospital in southern Vietnam

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Abstract

Objective

To determine the rate of positive culture sputum and related factors as well as the microorganism features and antibiotic susceptibility of pathogens in elderly inpatients with exacerbation of chronic obstructive pulmonary disease (COPD) in Thong Nhat Hospital, Vietnam.

Methods

This cross-sectional study included elderly patients admitted to the hospital because of exacerbation of COPD. Data of their medical history, symptoms and signs were collected, and the patients were instructed to collect sputum sample. A positive culture was identified with the growth of ≥ 105 colony-forming units per milliliter. Antibiotic susceptibility testing was performed according to the European Committee on Antimicrobial Susceptibility Testing.

Results

There were 167 participants (mean age: 77.5 ± 8.8 years, 87.4% male). The culture-positive rate was 25.1%. A higher proportion of positive culture was among participants with purulent sputum (p = 0.029) and with severe and very severe airflow obstruction (p = 0.005). Three most common agents were Acinetobacter baumannii (24.4%), Klebsiella pneumoniae (22.2%), and Pseudomonas aeruginosa (15.6%). Despite high resistance to almost other antibiotics (> 50% resistance), Acinetobacter baumannii and Pseudomonas aeruginosa were sensitive to colistin, tobramycin, and gentamicin (> 80% susceptibility). Klebsiella pneumoniae was highly sensitive to almost common antibiotics (> 80% susceptibility). Among Gram-positive pathogens, methicillin-resistant Staphylococcus aureus (MRSA) was completely sensitive to vancomycin, teicoplanin, and linezolid.

Conclusion

The sputum culture-positive rate in this study was not high. Most prevalent isolated pathogens were Acinetobacter baumannii, Klebsiella pneumoniae, and Pseudomonas aeruginosa. Acinetobacter baumannii and Pseudomonas aeruginosa were sensitive to tobramycin, gentamicin, and colistin. Commonly used antibiotics remained effective against Klebsiella pneumoniae. MRSA was sensitive to vancomycin, teicoplanin, and linezolid.

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Authors and Affiliations

  1. Pham Ngoc Thach University of Medicine, 02 Duong Quang Trung Street, District 10, Ho Chi Minh City, Vietnam

    Dung Si Ho, Hung Cao Dinh, Thanh Dinh Le, Dung Thuong Ho & Cong Duc Nguyen

  2. Thong Nhat Hospital, 01 Ly Thuong Kiet Street, Tan Binh District, Ho Chi Minh City, Vietnam

    Dung Si Ho, Thanh Dinh Le, Dung Thuong Ho & Hoang The Ngo

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  1. Dung Si Ho
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Correspondence to Cong Duc Nguyen.

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Ethical approval was obtained from the local ethics committee of Thong Nhat Hospital, Ho Chi Minh City, Vietnam (reference number: 11/2019/BVTN-HĐYĐ).

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Ho, D.S., Dinh, H.C., Le, T.D. et al. Sputum culture and antibiotic resistance in elderly inpatients with exacerbation of chronic obstructive pulmonary disease at a tertiary geriatric hospital in southern Vietnam. Aging Clin Exp Res 35, 1347–1356 (2023). https://doi.org/10.1007/s40520-023-02401-2

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