Sputum bacteriology in patients with acute exacerbations of COPD in Hong Kong

Abstract

Study objective: To study the demographics and sputum microbiology of patients admitted to a teaching hospital with acute exacerbations of chronic obstructive pulmonary disease (AECOPD).

Design: A retrospective study.

Setting: A tertiary university hospital in Hong Kong.

Patients: All episodes of AECOPD, patient demographics, length of stay, sputum culture and radiological results admitted in the first half of the year 2000 were retrieved from hospital records.

Results: There were 329 patients with 418 episodes of AECOPD without concomitant pneumonia. The age of the patients was 74.4+/-8.3 years. The acute hospital length of stay for an episode of AECOPD was 7.3+/-6.5 days. Haemophilus influenzae was the commonest organism found in sputum (23.1%), followed by Pseudomonas aeruginosa (6.3%) and Streptococcus pneumoniae (4.0%). Mycobacterium tuberculosis was found in 1.1% of the admissions. Presence of organisms in sputum had no association with the hospital length of stay and intensive care unit admissions. In patients whose FEV1 was >50% of predicted values, there was a higher chance of positive sputum growth of H. influenzae than those with FEV1 <50% (16/44 vs. 31/162 episodes, respectively, P=0.02).

Conclusions: H. influenzae was the commonest bacterium isolated in sputum in patients with AECOPD. In areas endemic of tuberculosis, it is advisable to use fluoroquinolones for AECOPD with caution.