BACTERIOLOGICAL PROFILE AND ANTIBIOTIC RESISTANCE PATTERN IN PATIENTS WITH ACUTE EXACERBATION OF BRONCHIECTASIS

Original Article

Abstract

Background: Bronchiectasis is a chronic respiratory condition characterized by irreversible bronchial dilatation and recurrent infections, often leading to acute exacerbations that significantly increase morbidity and healthcare burden. Bacterial infections are the primary cause of these exacerbations, and the rising prevalence of antibiotic-resistant pathogens has complicated effective management.

Objective: To determine the bacteriological profile and antibiotic resistance pattern in patients with acute exacerbation of bronchiectasis.

Study Design: Descriptive case series.

Place and Duration of Study: Department of Pulmonology, Allama Iqbal Medical College/Jinnah Hospital, Lahore, from 01 December 2024 to 30 May 2025.

Methodology: A total of 163 patients with acute exacerbation of bronchiectasis were included using a non-probability consecutive sampling technique. Sputum samples were collected and cultured to identify bacterial pathogens. Antibiotic susceptibility testing was performed using the disc diffusion method. Clinical and demographic data were obtained from medical records. Data were analyzed using SPSS version 20, and a p-value of ≤0.05 was considered statistically significant.

Results: The mean age of patients was 63.4 ± 12.5 years. The most commonly isolated pathogen was Pseudomonas aeruginosa (40%), followed by Haemophilus influenzae (11.6%), Staphylococcus aureus (7.0%), Klebsiella pneumoniae (5.8%), and Streptococcus pneumoniae (5.5%). Significant resistance was observed to beta-lactams (p < 0.01) and fluoroquinolones (p = 0.03). Patients with multidrug-resistant organisms had prolonged hospital stay (p = 0.02) and increased mortality (p = 0.01).

Conclusion: There is a high prevalence of antibiotic-resistant pathogens in acute exacerbation of bronchiectasis. Culture-guided antibiotic therapy and continuous local antimicrobial surveillance are essential to improve clinical outcomes and reduce morbidity and mortality.