Analysis of bacterial characteristics in sputum and their relationship with clinical and paraclinical symptoms in acute exacerbations of chronic obstructive pulmonary disease

SUMMARY: Chronic obstructive pulmonary disease (COPD) is a widespread condition with increasing prevalence globally. Sputum bacterial analysis aids in guiding initial antibiotic treatment. This study aimed to analyze bacterial characteristics using Real-Time PCR and sputum culture, and to explore their association with clinical and paraclinical features during acute exacerbations of COPD. A cross-sectional, comparative, prospective study was conducted on 180 inpatients at the Vietnam National Lung Hospital between January 2016 and June 2021. Clinical and paraclinical data were collected from the patients. The mean age of participants was 69.4 ± 9.4 years. Positive bacterial cultures were found in 37.2% of cases, while 62.8% were negative. The predominant Gram-positive bacteria identified included P. aeruginosa (20.9%), H. influenzae (17.9%), S. pneumoniae (11.9%), and A. baumannii (10.4%). Atypical bacteria detected via PCR included L. pneumophila (11.9%) and M. pneumoniae (4.5%). P. aeruginosa, H. influenzae, S. pneumoniae, and A. baumannii were highly sensitive to moxifloxacin, ceftriaxone, and cefotaxime. Patients with positive cultures had higher white blood cell counts, CRP levels, and procalcitonin (p<0.05). These findings support the use of bacterial susceptibility data to inform antibiotic choices, preventing unnecessary use of broad-spectrum antibiotics and reducing the risk of resistance development. Keywords: COPD, exacerbation, Real-Time PCR, Vietnam.