Bacteriology in acute exacerbation of chronic obstructive pulmonary disease in patients admitted to hospital

TY - JOUR

T1 - Bacteriology in acute exacerbation of chronic obstructive pulmonary disease in patients admitted to hospital

AU - Larsen, Mette V

AU - Janner, Julie H

AU - Nielsen, Susanne D

AU - Friis-Møller, Alice

AU - Ringbaek, Thomas

AU - Lange, Peter

N1 - Keywords: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Child; Child, Preschool; Culture Media; Female; Gram-Negative Bacterial Infections; Haemophilus influenzae; Hospitalization; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Moraxella (Branhamella) catarrhalis; Pseudomonas aeruginosa; Pulmonary Disease, Chronic Obstructive; Sputum; Young Adult

PY - 2009

Y1 - 2009

N2 - We investigated the bacterial flora and antimicrobial sensitivity in sputum from patients admitted to hospital with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in order to recommend the best empirical treatment for these patients. The survey was a retrospective study of all patients admitted to Hvidovre hospital with the diagnosis AECOPD during 2004. A total of 118 patients were included. Microscopy, culture and sensitivity testing investigated their sputums. Clinical and paraclinical features were collected from the patients' files. Among the 118 patients, 59 (50%) had a positive sputum culture. The group with positive cultures had a higher blood neutrophil count (p=0.03). There were no other clinical differences between the groups with and without positive sputum culture. The majority of patients with positive sputum cultures were infected with bacteria other than S. pneumonia, mostly H. influenzae and Moraxella catarrhalis. Patients with low FEV(1)<1.0 litre were more likely to be infected with Pseudomonas aeruginosa (p=0.03). The sensitivity patterns of the bacteria showed that the majority were resistant to penicillin. If antibiotics are initiated empirically for AECOPD we recommend either cefuroxime for intravenous treatment or amoxicillin-clavulanate for oral treatment.

AB - We investigated the bacterial flora and antimicrobial sensitivity in sputum from patients admitted to hospital with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in order to recommend the best empirical treatment for these patients. The survey was a retrospective study of all patients admitted to Hvidovre hospital with the diagnosis AECOPD during 2004. A total of 118 patients were included. Microscopy, culture and sensitivity testing investigated their sputums. Clinical and paraclinical features were collected from the patients' files. Among the 118 patients, 59 (50%) had a positive sputum culture. The group with positive cultures had a higher blood neutrophil count (p=0.03). There were no other clinical differences between the groups with and without positive sputum culture. The majority of patients with positive sputum cultures were infected with bacteria other than S. pneumonia, mostly H. influenzae and Moraxella catarrhalis. Patients with low FEV(1)<1.0 litre were more likely to be infected with Pseudomonas aeruginosa (p=0.03). The sensitivity patterns of the bacteria showed that the majority were resistant to penicillin. If antibiotics are initiated empirically for AECOPD we recommend either cefuroxime for intravenous treatment or amoxicillin-clavulanate for oral treatment.

U2 - 10.1080/00365540802484828

DO - 10.1080/00365540802484828

M3 - Journal article

C2 - 18855228

SN - 2374-4235

VL - 41

SP - 26

EP - 32

JO - Infectious Diseases

JF - Infectious Diseases

IS - 1

ER -