Pattern of Bacterial Infection in Acute Exacerbation of Chronic Obstructive Pulmonary Disease (COPD) in a Tertiary Care Hospital

Abstract

Background: Acute exacerbation of COPD is one of the important problems during management of COPD & has considerable impact on morbidity, mortality and quality of life. Acute exacerbation can occur due to bacterial or viral infection & non-infectious causes. Sputum culture & real-time PCR can identify the pattern of bacterial infection. Rational use of antibiotic can reduce the cost of treatment & possibility of antibiotic resistance.

Material and Methods: This cross sectional study was conducted on hospital admitted & outdoor attended acute exacerbation of COPD patients using sputum Gram stain, culture & Real time PCR.

Results: The mean age of the respondents was 60.02±10.55 years. Maximum patients 49(79.0%) age above 50 years followed by 13(21.0%) below 50 years. Most patients had dyspnea 54(87.1%) followed by increased sputum volume 31(50.0%), increased wheez or cough 23(37.1%), increased sputum purulence 19(30.6%). Considering sputum culture & RT-PCR, 29(46.8%) patients was found microbiologically positive. Klebsiella was isolated most frequently 10(34.5%) followed by Haemophilus 7(24.1%). Type 1 & type 2 AECOPD

showed more bacteriological positivity than type 3 (85.7%, 80.8% & 6.9% respectively, p=<0.001). Bacteria isolation was significantly associated with increased sputum purulence & volume (89.5% & 67.7% respectively, p=<0.001) but not in case of dyspnea (48.1%, p=0.573).

Conclusion: In conclusion, bacterial isolation was more common in type 1 & type 2 AECOPD than type 3, Klebsiella infection was most common. Increased sputum purulence & volume significantly indicates bacterial infection in AECOPD.

Chest Heart J. 2025; 49(1) : 15-21