Perspective Analysis of Microbial Pathogens in Acute Exacerbation of Asthma: Insights from the Tertiary Care Center of North India – A Hospital-based Prospective Study

BACKGROUND: Acute exacerbations (AE) of asthma significantly increase emergency room visits and hospital admissions, impacting patients' quality of life and healthcare costs. In India, asthma prevalence varies between 2% and 20%, affecting 15-20 million people. Microbiological pathogens such as viruses, bacteria, and fungi exacerbate asthma symptoms. MATERIALS AND METHODS: This was a hospital-based cross-sectional study, in which a total of 66 patients (based on proportion calculation) with the diagnosis of AE of bronchial asthma were enrolled as per the inclusion and exclusion criteria. The sputum collected from the patients was subjected to Gram Stain, culture and sensitivity, fungal stain and culture, and nasopharyngeal swabs were subjected for RT PCR of viral organisms to determine the microbiological profile. RESULTS: The mean age of the study participants was 43 ± 12 years. Out of 66 patients, bacterial growth was found in 40 (60.60%) samples. Gram-negative bacteria were more prevalent, isolated in 25 cases (62.50%), whereas Gram-positive organisms were identified in 15 cases (37.50%). The most common isolated pathogen was Klebsiella pneumoniae in 13 (19.69%), followed by Pseudomonas in 8 (12.12%) and Streptococcus pneumonia found in 7 (10.60%) cases. Viral organism was detected in 15.15% (10) cases, and Rhinovirus 6 (9.09%) was the most common, and Aspergillus was isolated in 6 (9.09%) cases only. CONCLUSION: AE of asthma are associated with a heterogeneous microbiological profile. The findings of this study highlight the importance of comprehensive microbiological evaluation in acute exacerbations of asthma to guide targeted therapy, minimize unnecessary antibiotic use, and strengthen antimicrobial stewardship practices in tertiary care settings.