Study on sputum bacteriology, antibiotic sensitivity pattern, and length of hospital stay in acute exacerbation of chronic obstructive pulmonary disease in a tertiary care hospital

Introduction: Acute exacerbation is a common event in the natural course of chronic obstructive pulmonary disease (COPD). Bacterial infections remain the leading cause of acute exacerbations of COPD (AECOPD), contributing significantly to morbidity, mortality, and healthcare utilization. Aims: To evaluate sputum bacteriology and antibiotic sensitivity patterns in patients with AECOPD, and to assess their association with mean duration of hospital stay and clinical outcomes. Materials and methods: This single-center prospective observational study was conducted from November 2022 to May 2024. Sputum culture and sensitivity reports of 95 patients admitted with AECOPD were analyzed. Statistical analysis was performed, and a P -value <0.05 was considered statistically significant. Results: Of the 95 patients (73 males, 22 females), 57 (60%) had positive sputum cultures. Most sputum samples were mucopurulent (58.9%), followed by mucoid sputum (41.1%). Gram-negative organisms were predominant (54.7%). The most common isolates were Klebsiella pneumoniae (27; 47.37%), Acinetobacter baumannii (9; 15.79%), Escherichia coli (9; 15.79%), Pseudomonas aeruginosa (7; 12.28%), and Staphylococcus aureus (5; 8.77%). Most isolates showed sensitivity to β-lactams and aminoglycosides, followed by quinolones. High sensitivity was observed to meropenem (32, 56.1%), piperacillin-tazobactam (30; 52.6%), amikacin (24; 42.1%), tigecycline (19; 33.3%), and imipenem (17; 29.8%). S. aureus isolates were sensitive only to linezolid, tigecycline, and teicoplanin. The mean duration of hospital stay was significantly higher in the culture-positive group (15.7 ± 2.4 days) compared with the culture-negative group (7.5 ± 1.2 days). Non-invasive ventilation was required in 40 (70.2%) culture-positive patients versus 5 (13.2%) culture-negative patients ( P < 0.0001). Mechanical ventilation was required in 12 (21.05%) culture-positive patients compared with 1 (2%) in the culture-negative group. Conclusion: Understanding local bacterial profiles in AECOPD can enable more effective and timely management. Sputum culture remains a simple and valuable tool for identifying infective exacerbations and guiding targeted empirical therapy, thereby reducing healthcare costs, morbidity, and mortality.