title: A multicentre surveillance study on the characteristics, bacterial aetiologies and in vitro antibiotic susceptibilities in patients with acute exacerbations of chronic bronchitis.
abstract: OBJECTIVE
  Antimicrobial resistance is a global problem and the prevalence is high in many Asian countries.
  
  
  METHODS
  A prospective observational study of the prevalence of bacterial pathogens and their antimicrobial susceptibilities in patients with acute exacerbations of chronic bronchitis (AECB) was conducted in Indonesia, Philippines, Korea, Thailand, Malaysia, Taiwan and Hong Kong from August 2006 to April 2008. The diagnosis of AECB was based on increased cough and worsening of two of following: dyspnoea, increased sputum volume or purulence. Patients who had taken antibiotics within 72 h of presentation were excluded. All bacterial strains were submitted to a central laboratory for re-identification and antimicrobial susceptibility testing to 16 antimicrobial agents according to Clinical and Laboratory Standards Institute.
  
  
  RESULTS
  Four hundred and seven isolates were identified among 447 patients of AECB. The most frequent organisms isolated were Klebsiella pneumoniae and associated species (n = 91 + 17), Haemophilus influenzae (n = 71), Pseudomonas aeruginosa (n = 63), Streptococcus pneumoniae (n = 32), Acinetobacter baumannii (n = 22) and Moraxella catarrhalis (n = 21). According to Clinical and Laboratory Standards Institute susceptibility breakpoints, 85.7% and >90% of these pathogens were susceptible to levofloxacin and cefepime respectively. Other options with overall lower susceptibilities include imipenem, ceftazidime, ceftriaxone and amoxicillin/clavulanate.
  
  
  CONCLUSIONS
  Gram-negative bacteria including Klebsiella spp., P. aeruginosa and Acinetobacter spp. constitute a large proportion of pathogens identified in patients with AECB in some Asian countries. Surveillance on the local prevalence and antibiotic resistance of these organisms is important in guiding appropriate choice of antimicrobials in the management of AECB.
authors.affiliation: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China. dschui@cuhk.edu.hk
authors.forename: David S
authors.initials: DS
authors.lastname: Hui
authors.forename: Margaret
authors.initials: M
authors.lastname: Ip
authors.forename: Thomas
authors.initials: T
authors.lastname: Ling
authors.forename: Shan-Chwen
authors.initials: SC
authors.lastname: Chang
authors.forename: Chun-Hsing
authors.initials: CH
authors.lastname: Liao
authors.forename: Chul-Gyu
authors.initials: CG
authors.lastname: Yoo
authors.forename: Deog-Kyeom
authors.initials: DK
authors.lastname: Kim
authors.forename: Ho-Il
authors.initials: HI
authors.lastname: Yoon
authors.forename: Visit
authors.initials: V
authors.lastname: Udompanich
authors.forename: Somkid
authors.initials: S
authors.lastname: Mogmeud
authors.forename: Razak
authors.initials: R
authors.lastname: Muttalif
authors.forename: Azmi M
authors.initials: AM
authors.lastname: Salleh
authors.forename: Camilo
authors.initials: C
authors.lastname: Roa
authors.forename: Myrna
authors.initials: M
authors.lastname: Mendoza
authors.forename: Concepcion
authors.initials: C
authors.lastname: Fajardo-Ang
authors.forename: Priyanti
authors.initials: P
authors.lastname: Soepandi
authors.forename: Fathiyah
authors.initials: F
authors.lastname: Isbaniah
authors.forename: Erlina
authors.initials: E
authors.lastname: Burhan
authors.forename: Pratiwi
authors.initials: P
authors.lastname: Sudarmono
authors.forename: Hadiarto
authors.initials: H
authors.lastname: Mangunnegoro
authors.forename: Hans H
authors.initials: HH
authors.lastname: Liu
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001208:Asia; D029481:Bronchitis, Chronic / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology*; D015897:Comorbidity; D018450:Disease Progression; D024881:Drug Resistance, Bacterial; D005260:Female; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D013183:Sputum / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents