Bacteria Profile and Antibiotic Resistance in Acute Exacerbations of COPD

Chronic obstructive pulmonary disease (COPD) is a progressive respiratory condition characterized by airflow limitation and recurrent exacerbations, significantly impacting morbidity and mortality. Acute exacerbations of COPD (AECOPD) are frequently triggered by bacterial infections, with antibiotic resistance complicating treatment strategies. This study aims to analyze bacterial profiles and antibiotic resistance patterns in patients with AECOPD. This observational cross-sectional study was conducted at Dr. Wahidin Sudirohusodo General Hospital, Makassar, Indonesia, from July 2023 to July 2024. Sputum samples from patients diagnosed with AECOPD were cultured and tested for antibiotic susceptibility. Bacterial identification was performed using standard microbiological methods, and antibiotic susceptibility was assessed using the Kirby-Bauer disk diffusion method. Statistical analysis was conducted to evaluate bacterial distribution and resistance patterns based on COPD severity. A total of 124 patients were included in the study, with a predominance of males (95.2%) and elderly individuals (≥65 years: 70.2%). Most patients were classified as having mild (44.4%) or moderate (52.4%) COPD exacerbations. Gram-negative bacteria were predominant (89.5%), with Klebsiella pneumoniae (42.7%) and Pseudomonas aeruginosa (25.8%) being the most frequently isolated pathogens. Antibiotic resistance was highest for ampicillin-sulbactam (76.6%), cefotaxime (72.3%), and tetracycline (68.8%), while lower resistance rates were observed for amikacin (4.6%) and levofloxacin (8.5%). Klebsiella pneumoniae and Pseudomonas aeruginosa are the dominant pathogens in AECOPD, with high resistance to commonly used antibiotics. These findings underscore the importance of continuous surveillance and antimicrobial stewardship to guide appropriate antibiotic therapy and improve patient outcomes.