Korean J Med.  2009 Sep;77(3):309-314.

Bacterial etiology in hospitalized patients with acute exacerbations of chronic obstructive pulmonary disease

• Joo SK
• Koo SW
• Kim MA
• Cho YH
• Cha ST
• Hong GY
• Kim EK
• Lee JH
• Hong SG
• Jeong HC

Abstract

(AECOPD). While critically ill patients requiring admission need proper antibiotic treatment for the causative pathogen, little is known about the bacterial etiology of AECOPD in Korea. We therefore studied the bacterial etiology of hospitalized patients with COPD in our institution.
METHODS
The study enrolled 149 patients who were admitted to the hospital in Sungnam with the diagnosis of AECOPD between July 1, 2004 and June 1, 2007. We retrospectively reviewed the clinical data and results of sputum cultures.
RESULTS
Of the 149 subjects with sputum collected, 51% (76 cases) had positive bacterial cultures [age 70.7+/- 9.2 years (mean+/- SD); 116 males] of sputum. Pseudomonas aeruginosa (24 cases, 30.4%) was the organism cultured in sputum most commonly, followed by Streptococcus pneumonia (15 cases, 18.9%), Acinetobacter sp. (9 cases, 11.4%), and Klebsiella pneumonia (7 cases, 8.9%). Patients whose FEV1 was <50% of the predicted value had a greater chance of showing positive growth of P. aeruginosa than patients having a FEV1 >50% (17/96 vs. 4/53, respectively, p=0.002). Patients taking systemic steroids also had a higher rate of sputum culture of P. aeruginosa (85.7%).
CONCLUSIONS
P. aeruginosa was the pathogen most commonly isolated in hospitalized patients with COPD. This species should be considered when physicians select empirical antibiotics to treat patients with AECOPD.

Keyword

Chronic obstructive pulmonary disease; Bacterial infection; Pseudomonas aeruginosa

MeSH Terms

Acinetobacter
Anti-Bacterial Agents
Bacterial Infections
Critical Illness
Humans
Klebsiella
Korea
Pneumonia
Pseudomonas aeruginosa
Pulmonary Disease, Chronic Obstructive
Retrospective Studies
Sputum
Steroids
Streptococcus
Anti-Bacterial Agents
Steroids