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P148 Bacteria profile of acute exacerbations of chronic obstructive pulmonary disease in Singapore
Poster Walks Poster Walk 2: Airway disease II
P148 Bacteria profile of acute exacerbations of chronic obstructive pulmonary disease in Singapore P.Y. Tiew1, M.S. Koh1, J.H.Y. Tan1, R.Y. Soh1, T.H. Ong1, C.M. Loo1, K.L.L. Tan1, S.H. Chotirmall2, T.S. Lapperre1 1 Respiratory Medicine, Singapore General Hospital, 2Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore Background: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are clinically relevant events with therapeutic and prognostic implications. Up to 50% of the AECOPD are associated with bacterial infections, such as Hemophilus influenzae, Streptococcus pneumonia and Moraxella catarrhalis. The differences in risk factor exposure, ethno-geography, genetic background and antibiotic resistance in Asia results in distinct bacterial profiles and antibiotic response during AECOPD. Data on Asian COPD cohorts is essential for patient management and antibiotic choice during AECOPD. Aim: To examine the prevalence and profile of bacteria isolated from sputum during AECOPD requiring hospitalization in Singapore, and its relation to clinical outcome in AECOPD. Method: Patients attending the Singapore General Hospital COPD clinic from 2013 to 2016 were studied. Clinical data including demographics, episodes of AECOPD and hospitalization history was obtained from a prospectively collected Redcap database and hospital electronic record system. Results: 100 patients were admitted for AECOPD with a total of 313 AECOPD recorded from January 2013 to June 2016. Mean patient age was 728 years; mean post-bronchodilator FEV1 was 46.818.3%pred with postbronchodilator FEV1/FVC ratio of 51.7 11.4. Of the 101 sputum cultures collected, bacteria were isolated in 40 (39.6%) sputum samples. The most common bacteria isolated were: Pseudomonas aeruginosa(N¼14), Hemophilus influenza(N¼10), Klebsiella pneumoniae(N¼8) and Acinetobacer baumannii(N¼8). A positive sputum culture during AECOPD was associated with an increased length of stay(6.35 days vs 3.46 days p¼0.014) and lower FEV1 %pred(mean 38.56 vs 51.75 p< 0.01). There was no significant difference in respiratory failure requiring ventilation(18.2%vs 18.5% p¼0.59) or blood inflammatory markers between the positive and negative sputum culture groups.
DOI:
http://dx.doi.org/10.1016/j.chest.2017.04.049
Copyright ª 2017 American College of Chest Physicians and Swiss Respiratory Society SGP. Published by Elsevier Inc and Karger. All rights reserved.
journal.publications.chestnet.org
45A
POSTER WALKS
Conclusion: Gram-negative bacteria, particularly Pseudomonas aeruginosa, were most frequently isolated during AECOPD requiring hospitalization in our cohort of COPD patients. Positive sputum cultures were associated with more severe airflow limitation and increased length of stay during AECOPD. Given the variation in bacteria identified in our cohort of patients, the selection of antibiotics during severe AECOPD in Singapore should include coverage of gram-negative bacteria particularly Pseudomonas aeruginosa that may reflect an Asian microbiological phenotype of COPD.
P148 Bacteria profile of acute exacerbations of chronic obstructive pulmonary disease in Singapore P.Y. Tiew1, M.S. Koh1, J.H.Y. Tan1, R.Y. Soh1, T.H. Ong1, C.M. Loo1, K.L.L. Tan1, S.H. Chotirmall2, T.S. Lapperre1 1 Respiratory Medicine, Singapore General Hospital, 2Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore Background: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are clinically relevant events with therapeutic and prognostic implications. Up to 50% of the AECOPD are associated with bacterial infections, such as Hemophilus influenzae, Streptococcus pneumonia and Moraxella catarrhalis. The differences in risk factor exposure, ethno-geography, genetic background and antibiotic resistance in Asia results in distinct bacterial profiles and antibiotic response during AECOPD. Data on Asian COPD cohorts is essential for patient management and antibiotic choice during AECOPD. Aim: To examine the prevalence and profile of bacteria isolated from sputum during AECOPD requiring hospitalization in Singapore, and its relation to clinical outcome in AECOPD. Method: Patients attending the Singapore General Hospital COPD clinic from 2013 to 2016 were studied. Clinical data including demographics, episodes of AECOPD and hospitalization history was obtained from a prospectively collected Redcap database and hospital electronic record system. Results: 100 patients were admitted for AECOPD with a total of 313 AECOPD recorded from January 2013 to June 2016. Mean patient age was 728 years; mean post-bronchodilator FEV1 was 46.818.3%pred with postbronchodilator FEV1/FVC ratio of 51.7 11.4. Of the 101 sputum cultures collected, bacteria were isolated in 40 (39.6%) sputum samples. The most common bacteria isolated were: Pseudomonas aeruginosa(N¼14), Hemophilus influenza(N¼10), Klebsiella pneumoniae(N¼8) and Acinetobacer baumannii(N¼8). A positive sputum culture during AECOPD was associated with an increased length of stay(6.35 days vs 3.46 days p¼0.014) and lower FEV1 %pred(mean 38.56 vs 51.75 p< 0.01). There was no significant difference in respiratory failure requiring ventilation(18.2%vs 18.5% p¼0.59) or blood inflammatory markers between the positive and negative sputum culture groups.
DOI:
http://dx.doi.org/10.1016/j.chest.2017.04.049
Copyright ª 2017 American College of Chest Physicians and Swiss Respiratory Society SGP. Published by Elsevier Inc and Karger. All rights reserved.
journal.publications.chestnet.org
45A
POSTER WALKS
Conclusion: Gram-negative bacteria, particularly Pseudomonas aeruginosa, were most frequently isolated during AECOPD requiring hospitalization in our cohort of COPD patients. Positive sputum cultures were associated with more severe airflow limitation and increased length of stay during AECOPD. Given the variation in bacteria identified in our cohort of patients, the selection of antibiotics during severe AECOPD in Singapore should include coverage of gram-negative bacteria particularly Pseudomonas aeruginosa that may reflect an Asian microbiological phenotype of COPD.