Results

7.0 RESULTS

A prospective observational study was enrolled 150 patients admitted to

pulmonology department diagnosed with infective exacerbation COPD. The patient’s
respiratory symptoms was monitored from the 1st day and the therapy was initiated.
Subjects were followed up. The individual bacterial isolates and their sensitive and
resistant pattern to various antibiotics were also recorded

PREVALENCE OF INFECTIVE EXACERBATION :

Diagnosis Frequency Percentage
Infective exacerbation 80 53%
others 70 47 %
Total 150 100%
Table No: 5 Diagnosis

Figure 6: Prevalence of infective exacerbation COPD

Out of 150 patients 80 patients (53%) are diagnosed with infective exacerbation
COPD and 70 (47%S) were others (fungal, viral ,environmental ).

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SOCIAL HABITS
SOCIAL HABITS FREQUENCY PERCENTAGE
Non-smoker 12 8%
Passive 4 3%
Ex-smoker 59 39%
Smoker 75 50%
Total 150 100
Table No: 6- Social habits

Figure 7: Smoking pattern

The entire population was classified into 4 categories based on social habits. In this
study, 50% of samples are current smokers,39% are Ex-smokers, 8% are non-smokers
and 3% are passive smokers.

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CATEGORISATION BASED ON OCCUPATIONAL RISK

OCCUPATION FREQUENCY PERCENTAGE

HOUSE WIFE 43 29 %
BLACK SMITH 18 12 %
CONSTRUCTION 21 14 %
MINNING 30 20 %
FLOUR MILL 10 6%
OTHERS 28 19 %

Table No: 8- Categorization based on occupational risk

Fig No: 8– Categorization based on occupational risk

Considering categorization based on occupational risk for developing infective
exacerbation COPD in house wives were (29%) , mining (20%) ,construction (14%),
black smith (12%), flour mill (6%) ,others (19%) .

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GENDER WISE DISTRIBUTION.

GENDER FREQUENCY PERCENTAGE

Male 103 69%
Female 47 31%
Total 150 100%
Table No: 9- Gender wise distribution

Fig No: 9 – Categorization based on gender

From the result the infective COPD was dominant in males (69%) compared to
females (31 %) .

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SOCIOECONOMIC STATUS:

Socioeconomic status FREQUENCY PERCENAGE

Upper 12 8%
Upper middle 20 13%
Lower middle 60 40%
Upper lower 18 26%
Lower 40 13%
Total 150 100

Table No: 10- Socioeconomic status

Fig No: 10 – Socioeconomic status

 The entire study population is divided into five categories based on

socioeconomic status by using Kuppu swamy’s scale.
 From the entire population lower middle were dominant (40%), upper lower
(26%), upper middle (13%), lower middle(13%), upper (8%).

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ORGANISM ISOLATES

Organism isolates Frequency Percentage

Gram –ve 7 78%
Gram +ve 2 22%
Total 9 100%
Table No: 11- Categorization based on organism isolates

Fig No: 11 – Categorization based on organism isolate

 The sputum samples of 150 patients was examined in microbiology lab out of
45% were bacterial pathogens was observed, in this 22% are gram positive
and 78% gram negative.

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ORGANISM ISOLATE IN INFECTIVE AECOPD

ORGANISM FREQUENCY PERCENTAGE

Klebsiella pneumonia
Pseudomonas aeruginosa
Acinetobacter
Heamophilus influenza
Streptococcus pneumoniae
E.coli
Staphylococcus aureus
Moraxella catarrhalis
Burkholderia cepacia
Total
23 28.04
19 23.17
9 10.97
6 7.31
9 10.97
3 3.65
5 6.09
1 1.21
7 8.53
82 100

Table No: 12- Organism Isolate In Infective AECOPD

Fig No: 12– Organism Isolates In Infective AECOPD

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During sputum culture common pathogenic bacterias are :

 Klebsiella pneumonia 28.04%
 Pseudomonas aeruginosa 23.17%
 Acinetobacter 10.97%
 Haemophilus influenza 7.3%
 E.coli 10.97%
 Staphylococcus aureus 3.65%
 Moraxella catarrhalis 6.09%
 Burkholderia cepacia 1.21%
 Streptococcus pneumonia 8.53%

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ANTIBIOTIC RESISTANCE PATTERN

Resistance pattern of gram positive organism
Antibiotics S. aureus S. pneumonia

Azithromycin 60 % 15.56%

Erythromycin 60% 33.33%

Clindamycin 0% 16.67%

Penicillin 20% 0%

Ciprofloxacin 60% 0%

Cotrimoxazole 0% 15.56%

Amikacin 0% 15.56%

Table No: 13- Resistance Patterns Of Gram Positive Organisms

Fig No: 13– Antibiotic Resistance Pattern

S.pneumoniae shows more resistance erythromycin and S.aureus shows more
resistance to erythromycin ,azithromycin and ciprofloxacin.
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 Results

Antibiotic Resistance Patterns of Gram Negative Organism

Antibiotics P. H. Moraxella E.coli Klebsiella Acineto

aeruginosa influenza bacter
Amikacin 5.26% 0 0 0 23.80% 22.22%
Gentamycin 15.78% 0 0 0 23.80% 77.77%
Cotrimoxazole 5.26% 42.85% 66.66% 33.33% 38.09% 44.44%
Linezolid 0 0 0 16.67% 0 0
Tetracyclin 0 14.28% 0 0 0 0
Ciprofloxacin 15.78% 0 100% 16.67% 23.80% 66.66%
Penicillin 0 0 33.33% 0 0 0
Ampicillin 0 0 0 66.67% 66.67% 55.55%
Ceftriaxone 0 0 0 50% 47.61% 44.44%
Cefazolin 0 0 0 50% 61.90% 55.55%
Cefepime 42.10% 0 0 50% 52.38% 66.66%
Cefuroxime 0 0 0 83.33% 61.90% 55.55%
Ceftazidime 0 0 0 0 0 11.11%
Piperacillin 0 0 0 0 4.76% 0
Piperacillin 0 0 0 0 0 33.33%
+tazobactum
Meropenam 21.05% 0 66.67% 0 23.80% 44.44%
Erythromicin 0 0 66.67% 0 0 0
Levofloxacin 0 0 66.67% 0 0 22.22%
Imepenem 0 0 0 0 9.52% 55.55%

Table 14 :Antibiotic resistance pattern of gram negative oraganism

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Antibiotic resistance pattern towards Pseudomonas aeruginosa .

Figure 14 : Antibiotic resistance pattern of P.aeruginosa

Pseudomonas aeruginosa shows greater resistance to cefepime

Antibiotic resistance pattern towards Haemophilus influenza

H. influenza
42.85% Cot- Series1
rimoxazole

14.28% Tetra-
cylcin

1 2

Figure 15: Antibiotic resistance pattern of H.influenza

Heamophilus influenza shows greater resistance to co-trimoxazole

Antibiotic resistance pattern towards Moraxella

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 Results

Figure 16 : Antibiotic resistance pattern of Moraxella

Moraxella shows greater resistance to ciprofloxacin

Antibiotic resistance pattern to E.Coli

Figure 17 : Antibiotic resistance pattern of E.Coli

E.Coli shows greater resistance to Cefuroxime and ampicillin

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 Results

Figure 18 : Antibiotic resistance pattern of Klebsiella

Klebsiella pneumoniae shows greater resistance to ampicillin,cefazolin and
cefuroxime

90.00%
77.77%
80.00% Gentamycin
66.66% 66.66%
70.00% Ciprofloxacin Cefepime
55.55% 55.55% 55.55% 44.44% 55.55%
60.00% Ampicillin Cefazolin Cefuroxime Meropenem Imipenam
44.44% 44.44%
50.00% Cotrimoxazole Ceftriaxone 33.33%
Piperacillin+Tazob
40.00% actum

30.00% 22.20% 22.22%

Amikacin Levofloxacin
20.00% 11.11%
Ceftazidim
10.00%

0.00%
1 2 3 4 5 6 7 8 9 10 11 12 13 14

Figure 19 : Antibiotic resistance pattern of Acinetobacter

Acinetobacter shows greater resistance to gentamycin, cefepime and ciprofloxacin

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 Results

Antibiotic Sensitivity Pattern in Gram Negative Organism

Antibiotics klebsiella P. Acineto H. E.coli Moraxella

aeruginosa bacter influenza
Amikacin 76.2 89.47 66.67 28.57 100 0
Gentamicin 66.67 78.94 22.22 0 83.33 0
Cotrimoxazole 57.14 0 55.56 28.57 66.67 33.33
Linezolid 0 0 11.11 0 0 0
Tetracyclin 0 0 11.11 71.43 0 33.33
Ciprofloxacin 52.38 84.21 22.22 71.43 66.67 0
Penicillin 0 0 0 0 0 66.67
Ampicillin 9.52 0 0 0 0 66.67
Ceftriaxone 9.52 0 0 57.14 0 0
Cefazolin 4.76 0 0 0 0 0
Cefepime 47.62 36.84 22.22 71.43 50 0
Cefuroxime 9.52 0 0 0 16.17 0
Ceftazidime 9.52 0 0 71.43 0 33.33
Piperacillin 0 52.63 0 0 0 0
Piperacillin+ 9.52 10.53 0 0 0 0
Tazobactam 0 84.21 11.11 57.14 0 0
Meropenem 66.67 78.94 66.67 85.71 66.67 0
Imipenem 47.62 0 33.33 71.43 50 0

Table 15 : Antibiotic sensitivity pattern to gram negative organism .

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Figure 20 : Antibiotic sensitivity pattern of K.pneumoniae .

K.pneumoniae shows great sensitivity to amikacin, gentamycin,and meropenam.

Figure 21 :Antibiotic sensitivity pattern of P. aeruginosa.

P.aeruginosa shows great sensitivity to amikacin ciprofloxacin and
piperacillin+tazobactum.

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Figure 22 : Antibiotics sensitivity patterns of Acinetobacter .

Acinetobacter shows great resistance to amikacin and meropenam.

Figure 23:Antibiotic sensitivity pattern of H.influenza .

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 Results

H.influenza shows great sensitivity to Meropenam and cefepime.

Figure 24:Antibiotics sensitivity pattern of E.coli .

E.coli shows great sensitivity to amikacin and gentamycin.

Figure 25 :Antibiotics sensitivity pattern of Moraxella .

M.catarrhalis shows great sensitivity in penicillin,ampicillin ,chloramphenicol and
azetreonam .

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 Results

ANTIBIOTIC SENSITIVITY PATTERN IN GRAM POSITIVE ORGANISM

Antibiotics S .aureus S.pneumoniea
Cefazolin 80% 66.67%
Vancomycin 60% 33.33%
Linezolid 60% 33.33%
Ciprofloxacin 40% 0
Gentamycin 20% 0
Cotrimoxazole 20% 0
Imipenem 20% 0
Erythromycin 20% 16.67%
Rifampicin 10% 0
Levofloxacin 0 16.67%
Penicillin 0 83.33%
Azithromycin 0 33.33%
Amikacin 0 16.67%
Ampicillin 0 16.67%

Table 16 :Antibiotic sensitivity pattern of gram positive organisms.

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 Results

Antibiotic sensitivity pattern of

gram positive
7000%
6000%
5000%
4000% S. aureus
3000%
2000%
1000%
0%
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Va G r
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Figure 26 : Antibiotic sensitivity patterns of S.aureus .

S.aureus shows great sensitivity to linezolid .

Antibiotic sensitivity pattern of gram

positive
9000.00%
8000.00%
7000.00%
6000.00%
5000.00% Pneumoniae
4000.00%
3000.00%
2000.00%
1000.00%
0.00%
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zol zol yc kac yc azo xac icill icill ene yc yc pic xac yc
e fa m i m x o n p p m m m o m
Lin Ce nco Am enta imo rofl Pe Am Ime enta thro Rifa vofl thro
Va G otr Cip G Ery Le Azi
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Figure 27 : Antibiotic sensitivity patterns of S.pneumoniae .

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 Results

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