Bacteriology of acute COPD exacerbations in Tunisia

The role of bacteria including atypical germs in acute exacerbation of chronic obstructive pulmonary disease (COPD) in Tunisia has been variously appreciated. This is a descriptive and analytical study including patients with a mean age of more than 68.3 years hospitalized for COPD. Of the 240 patients included, 175 sputum cultures (73%) were considered significant, 29 cultures were positive (16.5%) and 31 germs were isolated, the most frequent being P. aeruginosa (25.8%), K. pneumoniae (16.2%), H. influenzae (13%) and S. pneumoniae (9.7%). The prevalence of C. pneumoniae, M. pneumoniae and C. burnetii infection was 8.4%, 9% and 6.6% respectively. No L. pneumophila infection was found. Anthonisen criteria were associated with a positive culture (p=0.04). In conclusion, the low positivity of quantitative sputum bacteriology and the high percentage of resistant strains with a predominance of exclusively multi-resistant pseudomonas may help in the management of patients with EABPCO. Key words. EABPCO, bacterial infection, atypical germs, bacterial resistance.