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

Sae Kyung Joo,; Seung Won Koo,; Mi Ae Kim,; Yang Hyun Cho,; Sung Tae Cha,; Gi Youn Hong,; Eun Kyung Kim,; Ji Hyun Lee,; Seong Geun Hong,; Hye Cheol Jeong,

Korean J Med > Volume 77(3); 2009 > Article

Original Article

The Korean Journal of Medicine 2009;77(3):309-314.

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

Sae Kyung Joo, Seung Won Koo, Mi Ae Kim, Yang Hyun Cho, Sung Tae Cha, Gi Youn Hong, Eun Kyung Kim, Ji Hyun Lee, Seong Geun Hong, Hye Cheol Jeong

만성폐쇄성폐질환 급성 악화로 입원한 환자의 세균성 원인

주세경·구승원·김미애·조양현·차성태·홍기연·김은경·이지현·홍성근·정혜철, Seung Won Koo, Mi Ae Kim, Yang Hyun Cho, Sung Tae Cha, Gi Youn Hong, Eun Kyung Kim, Ji Hyun Lee, Seong Geun Hong, Hye Cheol Jeong

Abstract

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. (Korean J Med 77:309-314, 2009)

Key Words: Chronic obstructive pulmonary disease; Bacterial infection; Pseudomonas aeruginosa