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1 Final year MBBS student, Madras Medical College, Chennai 2 Associate Professor of Microbiology, Thanjavur Medical College, Thanjavur *Corresponding Author Dr David Agatha Associate Professor of Microbiology, Thanjavur Medical College, Thanjavur Email: davidagatha@gmail.com, Mobile no.9444048079 Residential Address: No15 Dhanam Nagar, Mugalivakkam, Chennai-600125, India Abstract Acute Exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD) are a common cause of hospitalization. It could have either an infective or non-infective etiology. Primary line of treatment is administration of empirical antibiotic therapy. CRP (C Reactive Protein) levels may be used as a biomarker to increase confidence about administering antibiotics. Periodic isolation and determination of antibiotic sensitivity pattern of causative bacteria is essential to formulate appropriate treatment strategies and avoid indeterminate use of antibiotics, to avoid rise in resistance. This cross sectional study was undertaken to determine the prevalence and bacterial etiological agents of AECOPD and their antimicrobial susceptibility pattern, and to correlate serum CRP levels with the causative factor. Sputum samples obtained from 50 AECOPD patients was subjected to bacterial culture and antibiotic sensitivity testing. Venous blood samples were also collected on admission and was subjected to a Rapid Latex Agglutination Test to determine CRP levels. Prevalence of sputum culture positivity was 62%. Commonest bacterial isolates were Klebsiella pneumonia (49%) and Pseudomonas aeruginosa (24%) . Extended spectrum beta lactamase was detected in 13.6% of enterobacteriaceae. Culture positivity was significantly higher in patients with purulent sputum as compared to non-purulent sputum. (p value=0.002). Serum CRP levels showed significant correlation with sputum purulence (p value=0.001) and culture positivity (p value= 0.003). Thus sputum bacteriology results and the antibiotic resistance pattern provide guidance for the choice of empirical antibiotic treatment for COPD patients with clinical evidence of airway infection such as increased sputum purulence and elevated serum CRP levels.

Sputum bacteriology, antibiotic sensitivity pattern and C reactive protein levels in patients of COPD with acute exacerbations