Bacteriological Profile in Acute Exacerbation of Chronic Obstructive Lung Disease (AECOPD).

Background: In COPD, acute exacerbation is the common problem during natural course. Studies of sputum samples using standard culture and molecular techniques have demonstrated that it is associated with increased prevalence of bacteria. Methods: 200 clinically diagnosed cases of AECOPD of age ≥45 years were recruited. Two sputum samples each were processed by conventional methods. Preparation of media, reagents, Gram staining, identification of culture isolates, different tests, including antibiotic sensitivity tests were carried out following standard laboratory. Results: The prevalence of AECOPD was more common in the age group of fifty six to sixty five years (43%) with ratio between male and female of 2.12:1. Klebsiella pneumonia was the predominant organism isolated in 42.55%, followed by Staphylococcus aureus in 28.73%, P. aeruginosa in 14.89%, E coli in 8.51%, CONS in 4.26% and S. pneumoniae in 1.06%. Gram negative bacteria were most sensitive to meropenem, imepenem, amikacin, followed by cefotaxime ceftriaxone, levofloxacin, Cefepime and aztreonam. Gram-positive bacterial isolates were most sensitive to linezolid (34.04%) followed by vancomycin (32.98%), cefoxitin (31.91%).Conclusion: Sputum culture is a good and simple diagnostic tool to study the etiology due to bacteria in AECOPD. Antibiogram helps in the formation of the correct treatment protocol, screening resistant pathogens and better drug for treatment, thereby helping to decrease the mortality and morbidity.

Prevalence of Subclinical Peripheral Neuropathy in Chronic Obstructive Pulmonary Disease.

Background: Present study aimed to assess peripheral neuropathy in stable COPD patients, its prevalence, type and distribution and correlate the changes with severity of COPD. Methods: Study comprised of 60 healthy adults and 60 stable nonalcoholic and normo-glycemic COPD patients (30-70yrs) with no clinical symptoms and signs of neuropathy. Severity of COPD was classified as per WHO GOLD criteria. Nerve conduction study of four motor and four sensory nerves of upper and lower limb was done and parameters like distal latency, amplitude and conduction velocity was studied. Results: Study revealed prolonged distal latency, reduced conduction velocity and reduced amplitude in COPD patients as compared to controls. More number of nerves involved with increasing severity of disease. The observations revealed that demyelinating motor and axonal sensory neuropathy can be seen in COPD patients and neuropathy occurred even in mild COPD patients. Conclusion: Sensory polyneuropathy predominant in lower limb was present in majority of patients.