Title : Clinico bacteriological characteristics and clinical outcomes in acute exacerbation of COPD: A 2-year retrospective review of patient data
Abstract:
Introduction: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) significantly contribute to morbidity and mortality worldwide. Understanding the demographic, clinical, microbiological characteristics, and outcomes of AECOPD patients is essential for optimizing management strategies.
Methods: This retrospective study analysed 143 medical records of patients admitted with AECOPD at Vicente Sotto Memorial Medical Center from January 2022 to December 2023. Demographic data, clinical presentations, bacterial culture results, antibiotic susceptibility patterns, and clinical outcomes were systematically extracted and analyzed.
Results: The majority of patients were males (79%) aged in their 60s (mean 66.4 ±12.4 years), with high prevalence of current smokers (72.7%), hypertension (44.1%), and prior pulmonary tuberculosis (25.2%). Common symptoms included dyspnea or orthopnea (86%) and increased sputum production (45.5%). In-hospital mortality was 38.5%, significantly associated with male sex, smoking, hypertension, prior tuberculosis, altered sensorium, and severe respiratory distress. Of the patients with bacterial cultures, 33.6% had growth predominantly of Klebsiella pneumoniae and Pseudomonas aeruginosa. Antibiotic susceptibility testing showed sensitivity primarily to Amikacin, with notable resistance to Amoxicillin/Clavulanic acid, Piperacillin/Tazobactam, and Ampicillin.
Conclusion: This study highlights that acute exacerbations of COPD remain a major clinical challenge, particularly among older male smokers with multiple comorbidities. The predominance of Klebsiella pneumoniae and Pseudomonas aeruginosa and their high resistance to commonly used antibiotics emphasize the growing threat of multidrug-resistant infections. These findings reinforce the need for culture-guided antibiotic therapy, strengthened antimicrobial stewardship, and comprehensive management addressing comorbidities and modifiable risk factors. Early recognition of severe symptoms and individualized interventions are essential to improve survival, reduce hospital mortality, and enhance the overall quality of care for patients experiencing acute COPD exacerbations.
Keywords: Acute exacerbation, COPD, bacterial pathogens, antibiotic resistance, clinical outcomes.
