Sputum bacteriology and antibiotic sensitivity pattern in COPD exacerbation in India

Abstract

Objective: To determine the bacteriology of COPD exacerbations in hospitalized patients of our institute, assessment of antibiogram and correlation of clinical and investigative profiles of patients. Design: 160 hospitalized and clinically diagnosed cases of AECOPD were evaluated for clinical characteristics, sputum bacteriology and antibiogram. Results: Sputum culture positivity was observed in 78 cases (48.7%). S. pneumoniae (13%) was the most common organism isolated. However collectively, gram negative bacteria (GNB) were the predominant etiological agent (35.7%). Among GNB, E. coli (9.4%) was the most common isolated organism followed by Acinetobacter (8.1%), P. aeruginosa (7.5%) and Klebsiella (6.3%). Spo2 < 80% (p = 0.002) and mucopurulent/purulent sputum (p < 0.05) had significant association with sputum positivity. S. pneumoniae, H. influenzae and M. catarrhalis were sensitive to antibiotics like fluoroquinolones, Cephalosporins, Aminoglycoside and Piperacillin-tazobactam. However, GNB showed significant resistance (p < 0.05) to the above antibiotic groups. Colistin and Polymyxin B were the only effective antibiotics against all the isolated organisms. Conclusion: With continuously changing bacterial flora of AECOPD, choice of antibiotic should be based on the local bacterial resistance pattern. Periodic studies to identify probable agents and their antibiotic sensitivity pattern would assist in formulating a cost effective antibiotic strategy reducing the emergence of drug resistance.

Keywords

• COPD
• Exacerbation
• Bacteriology
• Antibiogram