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Burden of bacterial exacerbation in bronchial asthma in Assiut University Hospitals, Egypt

The Egyptian Journal of Internal Medicine volume 29, pages 71–76 (2017)Cite this article

Abstract

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. Gram-negative 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.

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Authors and Affiliations

  1. Department of Internal Medicine, Faculty of Medicine, Assiut University, Assiut, 71515, Egypt

    Soheir M. K. Ahmed

  2. Microbiology and Immunology, Assiut University, Assiut, Egypt

    Mona S. E. Embarek Mohamed

  3. Chest Diseases, Faculty of Medicine, Assiut University, Assiut, Egypt

    Alaa T. Hassan

Authors
  1. Soheir M. K. Ahmed
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  2. Mona S. E. Embarek Mohamed
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  3. Alaa T. Hassan
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Correspondence to Soheir M. K. Ahmed.

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Ahmed, S.M.K., Embarek Mohamed, M.S.E. & Hassan, A.T. Burden of bacterial exacerbation in bronchial asthma in Assiut University Hospitals, Egypt. Egypt J Intern Med 29, 71–76 (2017). https://doi.org/10.4103/ejim.ejim_20_17

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  • DOI: https://doi.org/10.4103/ejim.ejim_20_17

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