CLINICAL AND MICROBIOLOGICAL PROFILE OF PATIENTS WITH ACUTE EXACERBATION OF COPD

Abstract

Aim: The Objectives of our study were to study the clinical profile and microbiological etiology of AE-COPD.

Methods: It was a hospital-based cross-sectional study, conducted in a tertiary care center and included patients hospitalized with a principal diagnosis of AE-COPD. Diagnosis of COPD was based on the GOLD guidelines. Detailed history, physical examination, sputum microbiology and blood investigations were recorded for all patients. All statistical analyses were done using Epi info 7.2.

Results: Mean age of the patients was 66.9 years. Majority of the patients (66) were ex-smokers, 26 were current- and 8 were never-smokers. One-third of the patients were frequent exacerbators. Most common co-morbidity was hypertension (25%) followed by diabetes (10%). Increased dyspnea was seen in all the patients, followed by increased quantity of sputum in 56. The most common clinical findings were use of accessory muscles of respiration in 92 patients, followed by crackles (84) and decreased breath sound intensity (62). Majority of the exacerbations (55%) were non-infectious, followed by 33% bacterial and 12% viral exacerbations. The most common isolated bacteria were Streptococcus pneumoniae (31%), Pseudomonas (27%) and Klebsiella (12%).

Conclusion: This study shows the common risk factors and clinical features presented by COPD patients hospitalized with severe exacerbation. Majority of the exacerbations were non-infectious, warranting further studies to determine the environmental factors. Although one-third of the exacerbations were bacterial, viruses were important etiological agents.