Médecine pulmonaire et respiratoire

Sputum Bacteriology and Antibiotic Sensitivity Pattern of Patients Having Acute Exacerbation of COPD in India – A Preliminary Study

Abstract

Anand K. Patel, Atul S. Luhadia and Shanti Kumar Luhadia

Background: Chronic Obstructive Pulmonary Disease (COPD) is a common disease and equally affecting rural population. Majority of COPD exacerbations are infective and facilities of bacterial culture are not available at peripheral health institutions. Acute exacerbations can contribute to irreversible progression of disease.

Objective: To find out the bacteria predominantly causing the AECOPD in our region, its relation with severity of the diseases and antibiotic most effective against these organisms.

Material and Methods: Previously diagnosed patients presented with acute exacerbation were investigated for sputum characteristics, culture and drug sensitivity.

Results: Culture was positive in 41 (82%) patients. Streptococcus pneumoniae (32%) was the most common pathogen isolated followed by Streptococcus pyogens (16%) and Pseudomonas (12%). Piperacillin+tazobactum was the most effective antibiotic against all organisms. Quinolones were less effective.

Discussion: Sputum culture was positive in 82% of patients with AECOPD which was higher as compare to other studies. On the contrary positive growth in 97% of samples has also been found. This difference may be because of the fact that culture positivity depends on nature of sputum, time of collection sputum and previous antibiotic use.

Conclusion: Streptococcus pneumoniae is still the most common pathogen in patients with AECOPD of this area. Piperacillin+tazobactum should be the first choice empirical antibiotic. Quinolones should be used cautiously in area where prevalence of tuberculosis is high. However more studies with larger population required which also includes bronchoscopic sampling along with sputum.