Bacterial Profile and Antibiotic Susceptibility Patterns of Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Assiut University Hospitals, Upper Egypt; a One-year Prospective Study

The majority of chronic obstructive pulmonary disease exacerbations are caused by infections of the tracheobronchial tree. Previous data on bacterial exacerbations of COPD in Upper Egypt are limited. Hence, this study was conducted for the identification of the causative bacteria in exacerbations of COPD, and to illustrate their antimicrobial susceptibility patterns at Assiut University Hospitals, Upper Egypt. A total of 116 COPD patients who underwent 167 infection exacerbation attacks participated in this prospective study during 2013. Significant bacterial growth was found in 143 (86%) out of the 167 exacerbation attacks. The most common detected bacteria were Haemophilus influenzae (19.4%), Escherichia coli (18%), Streptococcus pneumoniae (16.7%), Klebsiella pneumoniae (14%), Streptococcus pyogenes (10%), Pseudomonas aeruginosa (5.6%), methicillin resistant Staphylococcus aureus (5.6%), Acinetobacter baumannii (4.2%), and Moraxella catarrhalis (2.8%). The majority of the isolated strains showed high resistance rates to most groups of antibiotics where 91 (63%) of the isolated strains were multidrug resistant, 37 (26%) strains were extreme drug resistant and 16 (11%) bacterial strains were pandrug resistant. High resistance rates were observed against penicillins and cephalosporins. Moderate resistance rates were detected against the fluoroquinolones. High susceptibilities were detected to the carbapenem group. All the isolated Gram-positive bacteria were sensitive to linezolid.