Background
Asthma is one of the most common chronic respiratory diseases. Despite advances
in asthma management, acute exacerbations continue to occur and impose
considerable morbidity and mortality on patients and constitute a major burden
on healthcare resources.
Objective
This study aimed to determine the associations between bacterial infections
and adult asthma exacerbations, together with detection of antibiotic resistance
patterns in clinical practice.
Patients and methods
Sputa were collected from 60 adult asthmatic patients recruited from both Internal
Medicine Department and Chest Disease Department and their critical care units
during exacerbation attacks. Patients underwent thorough clinical examination,
laboratory investigations, and pulmonary function tests. Bacterial isolates were
identified using the standard diagnostic methods. Susceptibilities of the isolated
bacterial strains were determined using disk diffusion method.
Results
Significant bacterial growth was detected in 47 (78%) patients. Single etiological
agent was detected among 44 (73%) patients, whereas mixed infection was
found in three (5%) patients. A total of 52 bacterial strains were isolated from
our asthmatic patients. The predominant bacterial strains were as follows
in decreasing order: Streptococcus pneumoniae, Haemophilus influenzae,
Moraxella catarrhalis, Klebsiella pneumoniae, Staphylococcus aureus,
Acinetobacter baumannii, and Pseudomonas aeruginosa. Gram-negative bacilli
constituted 52% (27 isolates) of the total bacterial isolates during the exacerbation
attacks. Non-multidrug-resistant bacteria were 15 (30%) in number, 22 (44%)
bacterial isolates were multidrug resistant, six (12%) bacterial isolates were
extensively drug resistant, and seven (14%) isolates were pandrug resistant.
Conclusion
Acute exacerbation of asthma was associated with infection in most patients. Gramnegative
bacteria and S. pneumoniae form a relevant part of the microbial pattern of
exacerbation of asthma. Antibiotic resistance among bacterial strains remains a
challenge for the management of asthma exacerbations in clinical settings.