A study of clinical profile, sputum microbiology, and laboratory parameters of patients admitted with acute exacerbation of chronic obstructive pulmonary diseases in rural-based hospital.

BACKGROUND

Acute exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD) can increase morbidity and mortality significantly. Patients with AECOPD frequently present with worsening symptoms and deranged laboratory parameters. Bacterial infections in such patients are very common.

AIM AND

OBJECTIVES

To study and find out the relation between the clinical profile, sputum microbiology, and laboratory parameters of patients with AECOPD.

MATERIALS AND

METHODS

This was a cross-sectional study conducted on 150 patients admitted with AECOPD from January 2021 to December 2023.

RESULTS

Breathlessness was the commonest presenting symptom (100%), followed by productive cough (85.33%) and fever (78.66%). Mean white blood cell count (WBC) was 13,832/cmm3, which was raised in 87% of patients. Mean C-reactive protein (CRP) was 88.3, which was raised in 89% of patients, whereas the mean procalcitonin (PCT) was 1.05, which was on the higher side in 90% of patients. Sputum analysis revealed Gram-negative bacteria being isolated more, and Pseudomonas aeruginosa (38.33%) and Klebsiella pneumoniae (20%) were the predominant pathogens. Aminoglycosides (amikacin) were sensitive in 91%, followed by carbapenem (meropenem) in 87%, fluoroquinolones (levofloxacin), and penicillin with beta-lactamase inhibitor (piperacillin-tazobactum) were sensitive in 78%, and cephalosporins with beta-lactamase inhibitor (cefoperazone-sulbactam) were sensitive in 69% of patients.

CONCLUSION

Clinical findings and laboratory parameters of hospitalized patients of AECOPD suggested bacterial infections are common in AECOPD. Clinical parameters can be good predictors to start the treatment without waiting for culture and investigations. Data on sputum culture and antibiogram of such loco regional study will help to select and start antibiotics as early as possible in AECOPD.