A Cross-sectional Study on Sputum Bacteriology and Antibiogram with Inflammatory Marker, Clinical, and Functional Profile in Exacerbators of Chronic Obstructive Pulmonary Disease

INTRODUCTION: Globally, chronic obstructive pulmonary disease (COPD) ranks third in terms of morbidity and mortality. Chronic obstructive lung disease is a respiratory illness caused by partial or complete obstruction of the airflow. It is one of the joint conditions that can be treated, and it is marked by tissue degradation and a progressive restriction of airflow. It was linked to structural alterations in the lungs brought on by long-term inflammation caused by exposure to harmful particles or gases. AIM: To determine the sputum bacteriology in Exacerbations of hospitalized COPD patients and assess their antibiogram and their correlation with inflammatory markers, clinical and functional profile. MATERIALS AND METHODS: This cross-sectional study was conducted in the Department of Respiratory Medicine in a tertiary care center in Tamil Nadu, India. The study was conducted for a period of 18 months. A total of 104 patients with acute exacerbation of COPD aged more than 40 years were included in the study. After the initial assessment, a sputum examination was performed, followed by culture sensitivity, a spirometry evaluation, and the determination of the oxygen saturation in all the patients. RESULTS: One hundred four patients diagnosed with the acute exacerbation of COPD participated in the study. Sputum production is the most common symptom encountered in patients, followed by breathlessness. Purulent or mucopurulent sputum was noted in 57.6% of patients, sputum culture positivity in 62.5% of patients, and Klebsiella pneumoniae is the most common organism encountered in the sputum. Elevated C-reactive protein (CRP) levels and reduced Diffusion Capacity of the Lungs for Carbon Monoxide (DLCO) were noted in 85.6% of patients. Moreover, the study showed a significant association with age (P < 0.001), gender (P = 0.002), locality (P = 0.003), smoking (P < 0.001), alcohol (P = 0.004), exposure to indoor smoke (P = 0.001), type 2 diabetes mellitus (P < 0.001), coronary artery disease (P = 0.001), nature of sputum (P = 0.001), culture positivity (P = 0.001), spirometry (P = 0.025), and DLCO (P = 0.024) with elevated CRP levels and also with the all the clinical, spirometry, and saturation parameters with the culture positiveness. CONCLUSION: Numerous bacterial infections have been linked to the acute exacerbation of COPD; moreover, the bacterial infection profile differs depending on the geographic location. It is vital to periodically evaluate the patient's bacteriological profile to make sure it matches the organism's pattern of antibiotic resistance in order to lower the morbidity and mortality of the patient experiencing an acute exacerbation.