Source: Annual Congress 2002 - Acute exacerbations of COPD: aetiology and therapy
Disease area: Respiratory infections

Abstract

A total of 392 clinical isolates of Streptococcus pneumoniae (208 strains) and Haemophilus influenzae (184 strains), obtained between 1995 and 2001 from 227 COPD and 165 non-COPD patients with LRTI were investigated.
A 1 mcg oxacillin disk (BBL, USA) was used to discriminate between penicillin susceptible and intermediate-resistant/resistant S. pneumoniae strains according to the breakpoint suggested by the NCCLS (MIC: susceptible [lte]0.06 mcg/ml, inhibition zone : susceptible >=20 mm). A 15 mcg/ml erythromycin disk (BBL, USA) was used for testing susceptibility to macrolides (inhibitory zone : >=21 mm). To detect H. influenzae β-lactamase activity BBL Cefinase paper disk was used.
S. pneumoniae penicillin non-susceptible strains were found in 23/113 (20.3%) and in 10/95 (10.5%) of COPD and non-COPD patients (p=0.054;OR 2.11), respectively.
S. pneumoniae erythromycin resistant strains were detected in 32/113 (28.3%) and in 15/95 (15.8%) of COPD and non-COPD patients (p<0.05; OR 2.07), respectively.
H. influenzae β-lactamase production was found in 30/114 (26.3%) and in 5/70 (7%) of COPD and non-COPD patients (p=0.001; OR 4.30), respectively.
Our results show that COPD is associated with a significantly higher detection rate of antibiotic resistant bacteria. These data underlines the need of a cautious interpretation of epidemiologic data on antibiotic resistance.

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F. Blasi, R. Cosentini, P. Tarsia, V. Popescu-Janu, C. Gambardella, G. Graziadei, C. Canetta, L. Allegra (Milan, Italy). COPD is associated with high levels of bacterial antibiotic resistance. Eur Respir J 2002; 20: Suppl. 38, 3374

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