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KMID : 0882420090770030309
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Korean Journal of Medicine
2009 Volume.77 No. 3 p.309 ~ p.314
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Bacterial etiology in hospitalized patients with acute exacerbations of chronic obstructive pulmonary disease
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Joo Sae-Kyung
Koo Seung-Won
Kim Mi-Ae
Cho Yang-Hyun
Cha Sung-Tae
Hong Gi-Youn
Kim Eun-Kyung
Hong Seong-Geun
Jeong Hye-Cheol
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Abstract
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Background/Aims: Bacterial infections play an important role in acute exacerbations of chronic obstructive pulmonary disease (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.
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KEYWORD
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Chronic obstructive pulmonary disease, Bacterial infection, Pseudomonas aeruginosa
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