Bacteriological Profile in Exacerbation of Chronic Obstructive Pulmonary Disease (COPD)

Abstract

Chronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and mortality and represents a substantial economic and social burden throughout the world. This study examined the microbial pattern of COPD in both inpatient and outpatient in Shree Birendra hospital, Chhauni from November 2009 to February2010. To detect the pathogen responsible for exacerbation, sputum sample was collected.The sputum smear was examined microscopically and those containing less than 10 squamous epithelial cells and more than 25neutrophilswere only accepted.So out of 191 only 158 met the inclusion criteria.Different culture media were used toisolate the pathogens and antibiotics susceptibility pattern of the isolates was alsostudied using Kirby-Bauer’s disc diffusion method.There was significant association between age, spirometric value, number of exacerbations last year and color of sputum (p<0.001),; however, there was no significant association between sex,smoking habit, geographical distribution (living within valley and out of valley), fuel used for cooking purpose, previous history of hospitalization, family size with culture positive cases. Of the 158 sample, 70 (44.3%) were culture positive. The most common bacterium isolated was Streptococcus pneumoniae(20; 28.6%); the others included Klebsiella pneumoniae(15; 21.1%) Moraxella catarrhalis (13; 18.6%),Pseudomonas aeruginosa (12; 17.1%), Staphylococcus aureus (6; 8.6%), and Streptococcus pyogenes (4; 5.7%). Haemophillus influenzae was not isolated in any case.The most effective antibiotic inS. pneumoniae was found to be tetracycline and sulfomethoxazole (85%), ciprofloxacin (75%) in K. pneumoniae, amoxicillin/clavulinic acid and ceftazidime (92.3%) inM. catarrhalis, piperacillin/tazobactam (75%) in P. aeruginosa, methicillin and erythromycin (100%) in S. aureus and penicillin and cotrimoxazole (100%) in S. pyogenes.Streptococcus pneumoniae was the most predominant bacteria responsible for the exacerbation of COPD which was highly susceptible to tetracycline and sulfomethaxazole. Keywords: COPD, exacerbation,sputum culture.