Abstract

MICROBIAL ANALYSIS IN ACUTE EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASES AND THEIR ASSOCIATION WITH SEVERITY OF LUNG FUNCTION AND RESPIRATORY ACIDOSIS

Samta Shukla* and C. B. Shukla

ABSTRACT

Purpose: Chronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and mortality worldwide. . It is associated with frequent exacerbations and then hospitalizations. This study was designed to find out the microbial pattern and antibiotic sensitivity pattern for acute exacerbation of COPD in patients admitted to S.G.M Hospital, Rewa. Process: In order to study the bacteriological and mycological profile in such cases a total of 90 patients were enrolled in this study, these patients fulfilled the protocol criteria of reliable microbiologic result, reproducible lung function tests and respiratory Acidosis. The patients were categorized according to the three stages of severity of lung and presence or absence of Respiratory Acidosis. The male to female ratio was 2:1. Mean age of study group was 47 years. All patients had increased cough and sputum production. Gram staining, KOH mount preparation for fungi and sputum culture was done for all patients. IgG antibodies for M. pneumoniae by ELISA were estimated in all cases. Observation: The etiological diagnosis could be established in 92.2% cases, and in 7.8% cases Candida spp. were noticed as a common invader after antibiotic therapy. In acute infective exacerbations, S.aureus 24.5% (group I organism) followed by Klebsiella pnemoniae 18.4% (group III organism) were the predominant bacteria in patients having the stage III severity (FEV1 of 30% to 50% of the predicted value) of lung function test with the complaints of respiratory acidosis. Imepenem and Levofloxacin were the main antibiotics showed highest sensitivity towards isolated lung pathogens.

Keywords: COPD (Chronic Obstructive Pulmonary Diseases), Lung Function Test, FEV1 (Forced expiratory volume in one second), Exacerbation, Imepenem and Levofloxacin.