Role of bacteria in acute exacerbations of chronic obstructive pulmonary disease.
OBJECTIVE
Infections are major causes of acute exacerbations of chronic obstructive pulmonary disease (COPD) which result in significant mortality and morbidity. The primary aim of the study was to determine the microbiological spectrum including atypical agents in acute exacerbations. The secondary aim was to evaluate resistance patterns in the microorganisms.


METHODS
The sputum culture of 75 patients admitted to our clinic from January 1, 1999 to December 31, 2002 was evaluated prospectively, for aerobic Gram-positive and Gram-negative bacteria, and serologically for Chlamydophila pneumoniae and Mycoplasma pneumoniae. Sensitivity patterns in potentially pathogenic microorganisms (PPMs) were also investigated.


RESULTS
An infectious agent was identified in 46 patients, either serologically or with sputum culture. Pathogens most commonly demonstrated were: Haemophilus influenzae (30%), Chlamydophila pneumoniae (17%), and Mycoplasma pneumoniae (9%). Mixed infections were diagnosed in 9 patients. PPMs showed a high resistance rate to commonly used antibiotics.


CONCLUSIONS
We have shown that microorganisms causing acute exacerbations of COPD are not only typical bacteria (46%) but also atypical pathogens (26%), with unpredictable high rates. Typical agents showed a high resistance to commonly used antibiotics.
Erkan
Levent
L
Ondokuz Mayis University, Faculty of Medicine, Department of Pulmonary Medicine, Samsun, Turkey.
Uzun
Oguz
O
Findik
Serhat
S
Katar
Didem
D
Sanic
Ahmet
A
Atici
Atilla G
AG
D000328:Adult; D000368:Aged; D016993:Chlamydophila pneumoniae / Q000187:drug effects / Q000302:isolation & purification; D018450:Disease Progression; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009177:Mycoplasma pneumoniae / Q000187:drug effects / Q000302:isolation & purification; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000382:microbiology*; D013183:Sputum / Q000382:microbiology