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133603

Sputum bacterial profile and antibiotics sensitivity pattern in acute exacerbation of chronic obstructive pulmonary disease

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Last updated: 22 Jan 2023

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Abstract

ABSTRACT Background: Constant microbiologic screening of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is vital to control the possible alteration of pathogens, as well as their antibiotic resistance. Objective: to identify sputum bacterial profile and antibiotics sensitivity in patients with AECOPD aiming to adjust antibiotics use and reduce antibiotics resistance. Methodology: This cross-sectional study was conducted on 100 patients with AECOPD. The total and differential leucocytic count, spirometric-indices, sputum gram stain, sputum semi-quantitative culture using colony forming unit (CFU) were done for all patients. Additionally, assessments of the sensitivity of the isolated pathogenic bacterial species were done for 25 antibiotics by disk diffusion method. Results: by sputum semi-quantitative culture 28% of the studied patients have non-pathogenic bacterial growth (i.e., growth of normal flora) and 72% have pathogenic bacterial growth. Amongthose with pathogenic bacterial growth the isolated bacterial species in descending order were klebsiella (40.3%), staphylococcus aureus (19.4%), pseudomonas (12.5%), streptococcal pneumoniae, E. coli (8.3% each), acinetobacter (6.9%), citrobacter (2.8%) and enterobacter (1.4%). The most predictive factors for bacterial etiology in AECOPD in descending orders were decreased blood eosinophils % (B = - 0.16), increased blood neutrophils % (B = 0.04), increased blood lymphocytes (B = 0.02), and lower FEV1% (B = - 0.01). Levofloxacin was the most sensitive antibiotics (91.7%), followed by amikacin (88.9%), ciprofloxacin (87.5%) and gentamycin (87.5%) then imipenem (81.7%) and ofloxacin (76.4%). On the other hand, linezolid and vancomycin were the most resistant antibiotics (95.8% each), followed by clindamycin and cefotaxime (91.7% each) then colistin sulphate and tetracycline (90.3% each). Conclusion: Gram-negative bacterial species especially klebsiella was the most prevalent organism's in AECOPD. The isolated bacterial species were sensitive mainly to quinolones, gentamycin, amikacin, and imipenem, while it was mainly resistant to clindamycin, cefotaxime, colistin sulphate, tetracycline.

DOI

10.21608/jram.2020.52212.1103

Keywords

AECOPD, Bacterial species, Antibiotic sensitivity, bacterial susceptibility

Authors

First Name

Hala

Last Name

Abden

MiddleName

Y

Affiliation

Ayiat Chest Hospital, Giza, Egypt.

Email

halaabden4life@gmail.com

City

Giza-Egypt

Orcid

0000-0001-5237-9591

First Name

Manal

Last Name

Hafez

MiddleName

R

Affiliation

Chest Diseases Department, Faculty of Medicine, Girls, Cairo, Al-Azhar University, Egypt.

Email

dr.manalrefaat@gmail.com

City

Dakahlia

Orcid

0000-0002-7380-3977

First Name

Heba

Last Name

Eltrawy

MiddleName

H

Affiliation

Chest Diseases Department, Faculty of Medicine, Girls, Cairo, Al-Azhar University, Egypt.

Email

hebahamed.18@azhar.edu.eg

City

Cairo

Orcid

0000-0002-1261-6748

Volume

2

Article Issue

2

Related Issue

26940

Issue Date

2021-07-01

Receive Date

2020-12-04

Publish Date

2021-07-01

Page Start

173

Page End

183

Print ISSN

2636-252X

Online ISSN

2636-2538

Link

https://jram.journals.ekb.eg/article_133603.html

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https://jram.journals.ekb.eg/service?article_code=133603

Order

6

Type

Original Article

Type Code

676

Publication Type

Journal

Publication Title

Journal of Recent Advances in Medicine

Publication Link

https://jram.journals.ekb.eg/

MainTitle

-

Details

Type

Article

Created At

22 Jan 2023