Context Previous data on etiologic bacteria in acute
exacerbations of chronic obstructive pulmonary disease
(AECOPD) in Upper Egypt are limited.
Aim The aim of this study was to identify the causative
bacteria in AECOPD and to determine the antibiotic
resistance patterns for AECOPD in Upper Egypt.
Settings and design The study design was a prospective
one and was conducted in a University Hospital.
Materials and methods Patients who were admitted in
Assiut University Hospital with AECOPD were prospectively
enrolled. Sputum specimens were investigated using culture.
Susceptibilities of the isolated bacterial strains to different
antibiotics were determined using the disk diffusion method.
Results During 18 months, 156 patients who experienced
218 AECOPD were enrolled. A significant bacterial growth
was found in 77% of patients during 81% of exacerbations.
The most commonly detected bacteria were Haemophilus
influenzae (18%), Streptococcus pneumoniae (15%), and
Klebsiella pneumoniae (14%). The majority of the isolated
strains showed high resistance rates to most groups of
antibiotics; 63% of the isolated strains were multidrug
resistant, 29% were extensively drug resistant, and 5% were
pandrug resistant. High resistance rates were observed
against penicillins and cephalosporins, moderate rates
against fluoroquinolones, and lowest rates against the
carbapenems. All gram-positive bacteria were sensitive to
linezolid. Increased severity of chronic obstructive pulmonary
disease was related to increased prevalence of antibiotic
resistance.
Conclusion The predominant bacterial pathogens for
AECOPD in Upper Egypt are H. influenzae, S. pneumoniae,
and K. pneumoniae. Bacterial resistance rates were the
highest against penicillins and cephalosporins, moderate
against fluoroquinolones, and least against carbapenems.
Increased severity of chronic obstructive pulmonary disease
is related to an increased prevalence of antibiotic resistance.