DIAGNOSTIC VALUE OF SPUTUM CULTURE AND SENSITIVITY IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATIENTS AT HAYATABAD MEDICAL COMPLEX
DOI:
https://doi.org/10.71000/z1308145Keywords:
Chronic Obstructive Pulmonary Disease; Sputum Culture; Diagnostic Yield; Bacterial Pathogens; Antimicrobial Susceptibility; Antibiotic ResistanceAbstract
Background: Bacterial infection and airway colonization are clinically important in chronic obstructive pulmonary disease (COPD), particularly when patients experience worsening respiratory symptoms. Because the bacterial spectrum and antimicrobial resistance profile vary by geography and healthcare setting, local sputum-culture data are valuable for diagnostic and antimicrobial-stewardship decisions.
Objective: To assess the diagnostic value of sputum culture and sensitivity testing in COPD patients at Hayatabad Medical Complex (HMC), Peshawar, operationalized as culture yield, distribution of bacterial pathogens, and the available antimicrobial susceptibility pattern.
Methods: A hospital-based cross-sectional study was conducted in the Department of Pulmonology, HMC, from 25 January to 24 May 2025 after approval by the Research Review Board (No. 2364, dated 31 December 2024). A total of 107 hospitalized COPD patients aged 30-70 years were included. Patients with antibiotic use during the preceding two weeks, active pulmonary tuberculosis, lung carcinoma, immunocompromised status, or insufficient sputum samples were excluded. Sputum specimens were obtained by spontaneous expectoration or induction and processed in a designated reference laboratory. Data were analyzed in SPSS version 25.0. Culture yield was reported with a 95% confidence interval (CI), and associations with demographic and clinical characteristics were assessed using chi-square or Fisher exact tests as appropriate.
Results: Seventy-one of 107 sputum cultures were positive, giving a diagnostic yield of 66.4% (95% CI 57.0%-74.6%). Among positive cultures, Klebsiella pneumoniae was the most frequent isolate (22/71, 31.0%), followed by Pseudomonas aeruginosa (16/71, 22.5%), Streptococcus pneumoniae (10/71, 14.1%), Haemophilus influenzae (9/71, 12.7%), Staphylococcus aureus (6/71, 8.5%), Escherichia coli (4/71, 5.6%), and Moraxella catarrhalis (4/71, 5.6%). Reported resistance among Klebsiella pneumoniae included ceftriaxone and amoxicillin (7/22, 31.8% each), while ciprofloxacin resistance was recorded in 4/16 (25.0%) Pseudomonas aeruginosa isolates. No demographic or clinical subgroup showed a statistically significant association with culture positivity (all p>0.05).
Conclusion: Sputum culture identified a potentially pathogenic bacterium in approximately two-thirds of the studied COPD patients, with Gram-negative organisms predominating. Klebsiella pneumoniae and Pseudomonas aeruginosa were the leading isolates. The findings support the value of local sputum culture for organism identification and culture-guided management; however, incomplete antibiotic-specific susceptibility classification in the study dataset limits strong empirical-treatment recommendations.
Keywords: Chronic Obstructive Pulmonary Disease; Sputum Culture; Diagnostic Yield; Bacterial Pathogens; Antimicrobial Susceptibility; Antibiotic Resistance
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Copyright (c) 2025 Dr Fatima Fareed, Dr. Muhammad Asif Khan Afridi, Dr. Marhaba, Dr. Romesa Khattak, Dr. Nayab Shabir, Dr. Hira Rahim (Author)
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