Gram negative organisms as a cause of acute exacerbation of COPD

The clinical course of COPD is punctuated by acute exacerbations that have been defined as "a acute sustained worsening of the patient's condition, from the stable state, and necessitates a change in the regular medications. The cause of an acute exacerbation of COPD (AECOPD) is most often infectious and related to a viral and/or bacterial infection. Gram negative bacteria started to be a considerable etiology for AECOPD. The rational of the current study is to determine the Gram negative bacterial etiology of AECOPD in hospitalized patients in our institution and assess the incidence of multidrug resistance gram negative bacteria. 27 patients, 25 males and 2 females aged with a mean age of 62.6 years were included in the study. A detail history was elicited and complete examination was done. The sputum specimen was collected using sterile containers and subjected to Gram's stain, culture on blood agar. Sputum culture for pathogenic bacteria showed one or two isolates in 10 cases (37%) and mixed flora in 9 cases (33.3%), and there were no growth in 8 cases (29.7%). Gram negative bacilli 25.9% were more isolated than Gram positive cocci 11.1% The commonest isolate was Pseudomonas aeruginosa 3 (11.1%), followed by Klebsiella pneumoniae 2 (7.4%). The drug sensitivity reveals that the gram negative isolates were sensitive to Carbapenems (100%) followed by Aminoglycosisdes like Amikin. Multidrug resistant strains were only found in 28.6% of the gram negative organisms and 7.4% of the total cases of AECOPD. To conclude Gram negative bacteria were more frequently isolated in our patients, antimicrobial treatment should be started early depending on the antimicrobial sensitivity results, in the wake of an increasing rate of isolation of resistant organisms. (C) 2013 The Egyptian Society of Chest Diseases and Tuberculosis. Production and hosting by Elsevier B.V.