PURPOSE:
To identify the causative bacteria, antibiotic sensitivity and antibiotic resistance of acute exacerbation of COPD (AECOPD) in Upper Egypt considering this an important issue to be investigated in our locality.
METHODS:
A multicentre prospective study was performed for two years in Assiut, El-Minia and Sohag universities. Sampling was done for all patients including, sputum for gram stain and culture, and serum sample for serology. The validated sputum was cultured on three bacteriological media (Nutrient, Chocolate and MaConkey,s agar plates) . The colonies were processed for identification of micro-organisms by Automated Walkaway Microscan 96.Pneumoslide IgM kit (Vircell-slide) was used for detection of atypical pathogens through the use of serological indirect Fluorescent Antibody method.
RESULTS:
The predominant isolates in 376 patients with acute exacerbation of COPD (AECOPD) were Heamophilus Influnza (32%), streptococcus pneumonia (30%), Moraxella catarrhalis (14%), Klebsiella pneumoniae (10%) and chlamydia pneumoniae (7%). A higher sensitivity was recorded for Moxifloxacin, Levofloxacin, Macrolides, and Cefipime. A higher rate of resistance was recorded for tetracyclines, first or second generations cephalosporins and gentamicin.
CONCLUSIONS:
Heamophilus Influnza , streptococcus pneumonia are the predominant pathogens in nearly two third of patients with AECOPD in upper Egypt, Respiratory quinolones, macrolids and cefipime showed the highest sensitivity while tetracyclines, first or second generations cephalosporins and gentamicin shoed the lowest sensitivity in dealing with such excerbation
CLINICAL IMPLICATIONS:
Respiratory quinolones, cefipime and macrolides are the most efficient antibiotics in treatment of AECOPD in upper Egypt.