Mussema Abdulhakim, Beyene Getenet, Gashaw Mulatu
School of Medical Laboratory Science, Jimma University, Jimma, Ethiopia.
Department of Medical Laboratory Science, Wachemo University, Hosanna, Ethiopia.
Can J Infect Dis Med Microbiol. 2022 Aug 31;2022:9709253. doi: 10.1155/2022/9709253. eCollection 2022.
Chronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and mortality worldwide. The natural course of COPD is characterized by acute exacerbation. Infectious agents, particularly bacteria, cause exacerbation of COPD in the majority. This study aimed to determine the bacteriology and antibiotic resistance patterns among patients with acute exacerbations of COPD (AECOPD) at Jimma Medical Center.
A cross-sectional study was conducted from March to October 2019. Demographic, clinical, and sputa samples were collected from 39 study participants, who were diagnosed with AECOPD. Bacterial pathogens were identified using standard bacteriological techniques, and anti-microbial susceptibility testing was done by Kirby Bauer's disk diffusion method. Extended-spectrum -lactamase (ESL) and carbapenemase production were confirmed by MASTTM D68C and MASTTM D73C combination disc sets, respectively. Chi-square and odds ratios were calculated.
Overall, 69.2% (27/39) of sputum samples were confirmed to be culture-positive. A total of 32 bacterial isolates with 78.1% (25/32) Gram-negative and 21.9% (7/32) Gram-positive bacteria were identified. The predominant bacterial isolates were 21.9% (7/32), 18.75% (6/32), and 15.62% (7/32). Overall, 30 (93.8%) of the isolates were multidrug-resistant (MDR). About 48% (12/25) and 8 (32%)of gram negative bacterial isolates were ESBL betalatemase and OXA-48 carbapenemase producers, respectively. Having two or more exacerbation experiences in the previous year were found to be important determinants of the sputum culture positivity.
High rates of MDR, ESBL, and carbapenemase producer bacteria were isolated from patients with AECOPD. Empiric antibiotic therapy should consider the prevalence of antibiotic-resistant pathogens and the factor that may increase the occurrence of MDR bacterial pathogens.
慢性阻塞性肺疾病（COPD）是全球慢性发病和死亡的主要原因。COPD的自然病程以急性加重为特征。感染因素，尤其是细菌，在大多数情况下会导致COPD急性加重。本研究旨在确定吉姆马医疗中心慢性阻塞性肺疾病急性加重期（AECOPD）患者的细菌学及抗生素耐药模式。
于2019年3月至10月进行了一项横断面研究。从39名被诊断为AECOPD的研究参与者中收集人口统计学、临床和痰液样本。使用标准细菌学技术鉴定细菌病原体，并通过 Kirby Bauer 纸片扩散法进行药敏试验。分别用MASTTM D68C和MASTTM D73C组合纸片法确认超广谱β-内酰胺酶（ESL）和碳青霉烯酶的产生情况。计算卡方值和比值比。
总体而言，69.2%（27/39）的痰液样本培养呈阳性。共鉴定出32株细菌分离株，其中革兰氏阴性菌占78.1%（25/32），革兰氏阳性菌占21.9%（7/32）。主要的细菌分离株分别为21.9%（7/32）、18.75%（6/32）和15.62%（7/32）。总体而言，30株（93.8%）分离株为多重耐药（MDR）。革兰氏阴性菌分离株中分别约有48%（12/25）和8株（32%）为ESBLβ-内酰胺酶和OXA-48碳青霉烯酶产生菌。发现前一年有两次或更多次加重经历是痰液培养阳性的重要决定因素。
从AECOPD患者中分离出的多重耐药、ESBL和碳青霉烯酶产生菌的比例很高。经验性抗生素治疗应考虑抗生素耐药病原体的流行情况以及可能增加多重耐药细菌病原体发生的因素。
