title: Spectrum and antimicrobial resistance of common pathogenic bacteria isolated from patients with acute exacerbation of chronic obstructive pulmonary disease in mainland of China.
abstract: BACKGROUND
  Bacteria-induced respiratory infection has been long considered to be the major cause of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Therefore, a clear picture about the distribution and drug-resistance of pathogenic bacteria in the lower airways should be helpful for treatment of the disease. So far, data on this topic among Chinese are lacking.
  
  
  METHODS
  A surveillance study was performed in consecutive patients with AECOPD at five areas in China between October 2006 and April 2008. The sputum from these patients was cultured and isolated for bacteria. Agar dilution method was used to determine the minimal inhibitory concentrations (MICs) of levofoxacin and other 15 antibiotics against these strains.
  
  
  RESULTS
  Three hundred and fifty-nine pathogenic bacterial strains were isolated among 884 patients with AECOPD. The predominant bacteria were Pseudomonas aeruginosa (21.7%), Klebsiella pneumoniae (12.3%), Haemophilus influenzae (14.2%) and Streptococcus pneumoniae (11.7%), followed by Haemophilus parainfluenzae (9.5%), Acinetobacter baumannii (7.8%), Moraxella catarrhalis (6.4%) and Escherichia coli (3.6%). The majority of bacterial pathogens isolated in this study were susceptible to fuoroquinolones, ceftazidime, cefepime and imipenem.
  
  
  CONCLUSIONS
  Gram-negative bacilli are the leading pathogens in patients with AECOPD in China. Haemophilus parainfluenzae may be one of the most important pathogens in AECOPD. This study provides evidence for local surveillance of AECOPD pathogens and appropriate choice of antimicrobials in China.
authors.affiliation: Guangzhou Institute of Respiratory Diseases, First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, Guangzhou Medical University, Guangzhou, Guangdong 510120, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Ye
authors.forename: Li-Xian
authors.initials: LX
authors.lastname: He
authors.forename: Bo-Qiang
authors.initials: BQ
authors.lastname: Cai
authors.forename: Fu-Qiang
authors.initials: FQ
authors.lastname: Wen
authors.forename: Bai-Yi
authors.initials: BY
authors.lastname: Chen
authors.forename: Mangunnegoro
authors.initials: M
authors.lastname: Hadiarto
authors.forename: Rong-Chang
authors.initials: RC
authors.lastname: Chen
authors.forename: Jin-Ping
authors.initials: JP
authors.lastname: Yuan
authors.forename: Hong-Li
authors.initials: HL
authors.lastname: Sun
mesh_terms: D000208:Acute Disease; D000368:Aged; D001419:Bacteria / Q000187:drug effects*; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000382:microbiology*