TY - JOUR
T1 - Trends in the Bacterial Prevalence and Antibiotic Resistance Patterns in the Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Hospitalized Patients in South India
AU - Kaleem Ullah, Mohammed
AU - Malamardi, Sowmya
AU - Siddaiah, Jayaraj Biligere
AU - A, Tejashree
AU - Prashant, Akila
AU - Vishwanath, Prashant
AU - Riley, Lee W.
AU - Madhivanan, Purnima
AU - Mahesh, Padukudru Anand
N1 - Funding Information:
This work was supported by the National Institutes of Health (NIH), Fogarty International Center, Global Infectious Disease Research Training program (GID) [Grant D43TW010332-01A1 to L.W.R., P.M., and P.A.M.], and The Wellcome Trust DBT India Alliance [Grant IA/TSG/19/1/600026 to P.A.M.]. The funders had no role in the study design, data collection, and analysis, decision to publish, or preparation of the manuscript. The APC was funded by the National Institutes of Health (NIH), Fogarty International Center, Global Infectious Disease Research Training program (GID) [Grant D43TW010332-01A1 to L.W.R., P.M., and P.A.M.].
Publisher Copyright:
© 2022 by the authors.
PY - 2022/11
Y1 - 2022/11
N2 - Exacerbation due to antimicrobial-drug-resistant bacteria among chronic obstructive pulmonary disease (AECOPD) patients contributes to mortality and morbidity. We examined the prevalence of the bacterial organisms and trends in drug resistance in AECOPD. In this retrospective study, between January 2016 to December 2020, among 3027 AECOPD patients, 432 (14.3%) had bacteria isolated. The regression and generalized estimating equations (GEE) were used for trends in the resistance patterns over five years, adjusting for age, gender, and comorbidities. Klebsiella pneumoniae (32.4%), Pseudomonas aeruginosa (17.8%), Acinetobacter baumannii (14.4%), Escherichia coli (10.4%), and Staphylococcus aureus (2.5%) were common. We observed high levels of drug resistance in AECOPD patients admitted to ICU (87.8%) and non-ICU (86.5%). A Cox proportional hazard analysis, observed infection with Acinetobacter baumannii and female sex as independent predictors of mortality. Acinetobacter baumannii had 2.64 (95% confidence interval (CI): 1.08–6.43) higher odds of death, compared to Klebsiella pneumoniae. Females had 2.89 (95% CI: 1.47–5.70) higher odds of death, compared to males. A high proportion of bacterial AECOPD was due to drug-resistant bacteria. An increasing trend in drug resistance was observed among females.
AB - Exacerbation due to antimicrobial-drug-resistant bacteria among chronic obstructive pulmonary disease (AECOPD) patients contributes to mortality and morbidity. We examined the prevalence of the bacterial organisms and trends in drug resistance in AECOPD. In this retrospective study, between January 2016 to December 2020, among 3027 AECOPD patients, 432 (14.3%) had bacteria isolated. The regression and generalized estimating equations (GEE) were used for trends in the resistance patterns over five years, adjusting for age, gender, and comorbidities. Klebsiella pneumoniae (32.4%), Pseudomonas aeruginosa (17.8%), Acinetobacter baumannii (14.4%), Escherichia coli (10.4%), and Staphylococcus aureus (2.5%) were common. We observed high levels of drug resistance in AECOPD patients admitted to ICU (87.8%) and non-ICU (86.5%). A Cox proportional hazard analysis, observed infection with Acinetobacter baumannii and female sex as independent predictors of mortality. Acinetobacter baumannii had 2.64 (95% confidence interval (CI): 1.08–6.43) higher odds of death, compared to Klebsiella pneumoniae. Females had 2.89 (95% CI: 1.47–5.70) higher odds of death, compared to males. A high proportion of bacterial AECOPD was due to drug-resistant bacteria. An increasing trend in drug resistance was observed among females.
KW - bacterial
KW - bacterial infections/microbiology
KW - chronic obstructive/complications
KW - chronic obstructive/microbiology
KW - drug resistance
KW - hospital mortality
KW - multiple
KW - pulmonary disease
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U2 - 10.3390/antibiotics11111577
DO - 10.3390/antibiotics11111577
M3 - Article
AN - SCOPUS:85141675831
SN - 2079-6382
VL - 11
JO - Antibiotics
JF - Antibiotics
IS - 11
M1 - 1577
ER -