Study of Prevalence and Pattern of Infections in Acute Exacerbations of Obstructive Airway Disease

Objective: To study the prevalence and pattern of infections causing exacerbations of obstructive airway diseases. Methods: A prospective cross sectional study which included 126 consecutive obstructive airway disease patients were enrolled for the study. All the included patients were subjected to detailed history, clinical examination and routine investigations including sputum Gram’s stain and aerobic culture after obtaining a written informed consent. Pharyngeal swab was collected and sent in Viral Transport Medium(VTM, Himedia) within 24hrs to Regional Medical Research Centre (ICMR),Bhubaneswar for detection of respiratory viruses. Samples were tested by Real Time reverse-transcription polymerase chain reaction (RT-PCR). Results: Among patients with COPD, Flu A/H3N2(9.375%) was found in highest number of patients followed by rhinovirus(7.3%). In bronchial asthma patients,virus was isolated only in 3 cases(13.6%).No virus was detected in bronchiectasis patients. Isolated bacterial infection was detected in 26 cases (20.63%).Acinetobacter baumanii and Klesiella pneumoniae were most common bacterial pathogens detected.Bacterial pathogens were commonly isolated among COPD patients.Co-infection with both bacteria and virus was detected in 12 patients (9.52%)of which 11 were diagnosed with COPD. Only 1 case of bronchial asthma reported a co-infection.Among cases with co-infection with both bacteria and virus,Acinetobacter baumanii and  Pseudomonas aeruginosa were found to be most common bacterial pathogens.There was no typical pattern in viral infection among the cases throughout the year. Conclusion: The risk of exacerbation due to viral etiology is perennial but might be self limiting. Recovery from exacerbation takes a long time and patients with exacerbations have an impaired quality of life, diminished exercise capacity and loss of lung function.