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

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

A retrospective study.

A tertiary university hospital in Hong Kong.

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.

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).

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.