Acute Exacerbation of Chronic Obstructive Pulmonary Disease: Phenotypic Screening and Sensitivity of Microbiological Profile

Abstract

ABSTRACT Introduction: An upper respiratory tract infection which can be either due to increased airway bacterial load or emergence of new bacterial strain is the most common cause of Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD). Other factors responsible for exacerbation include viral infections, pollution and other unidentified pathogens. Aim: To evaluate the local pattern of bacterial and fungal isolates from patients diagnosed with AECOPD and forming an antibiogram of the hospital. Materials and Methods: A total of 200 clinically diagnosed cases of AECOPD of age ≥40 years were included in the study. Sputum sample was obtained from the patients and processed according to standard lab procedures. Statistical analysis was done by using Statistical Package for Social Sciences (SPSS) version-20. The test applied in the current study was modified chi-square used for comparison of proportion to analyse statistical significance for antibiotic sensitivity. The p-value <0.05 was considered statistically significant. Results: The prevalence of AECOPD was more common in the age group of 50-60 years (49.5%) with ratio between male and female of 2.8:1. Among gram negative isolates the most common was Klebsiella sp. (21.6%) followed by Pseudomonas aeruginosa (20.7%), Moraxella catarrhalis (16.5%), E.coli (7.6%), and Citrobacter sp. (7.0%). Among gram positive isolates the most common was Staphylococcus aureus (13.3%) followed by Streptococcus pneumoniae (9.5%), Enterococcus sp. (1.9%) and Coagulase negative Staphylococcus (1.9%). Gram negative and gram positive isolates were found sensitive to commonly used antimicrobials, fungal growth was seen in only 49 (24.5%) patients out of which 37 (75.5%) patients had Candida sp. and 12 (24.5%) patients had Aspergillus sp. and were sensitive to commonly used antifungals. Conclusion: Antibiogram helps in forming correct treatment protocol avoiding unnecessary use of antibiotics preventing drug resistance, decrease mortality and morbidity.

Keywords

• antibiogram
• fungal growth
• gram positive bacteria
• gram negative bacteria
• sensitivity pattern