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Purpose: The clinical aspects of antibiotic resistance (ABR) of patients in ambulatory practice with chronic obstructive pulmonary disease (COPD) are not investigated thoroughly. The aim of the present study is to find the most frequent respiratory pathogens of ambulatory COPD patients and to evaluate the resistance of their isolates to tested antibiotics. \udMaterial/Methods: For 3 year period 249 COPD patients from Pulmonary Ambulatory Practice in Pleven were retrospectively studied. Data were collected from medical documents. The sputum samples from the ambulatory COPD patients were tested via direct microscopy and on culture medium. The ABR of the isolates was tested. \udResults: Pathogens were isolated from 71 (28.5%) out of 249 sputum samples from COPD ambulatory patients. Most frequent isolates, we found were:  Pseudomonas aeruginosa- 5.22%, Hemophilus influenzae - 4.82%, Klebsiella pneumoniae - 4.42% and Esherichia coli - 3.61%. A significant correlation was found between ABR and the results from lung function testing. In patients with forced expiratory volume per 1 second - FEV1< 50%, antibiotic resistant isolates were found more frequently (χ2 =7.59, p=0.0059). Similar correlation was found among smokers. Resistant isolates were found more often among smoker than in non-smokers (χ2 = 5.01, p= 0.0252).\udConclusions: The regular microbiological testing of sputum samples, including in ambulatory practice, with determination of most frequent isolates and their ABR would be helpful for the good clinical practice.

SPUTUM ISOLATES FROM AMBULATORY PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE – FREQUENT PATHOGENS AND ANTIBIOTIC RESISTANCE