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P251 Importance of sputum culture in patients hospitalized for exacerbated chronic obstructive pulmonary disease

Introduction and objectives Patients with Chronic Obstructive Pulmonary Disease (COPD) suffer episodes of clinical instability characterized by worsening of respiratory symptoms, known as exacerbations. The most frequent etiology of the exacerbations are respiratory infections. Sputum cultures can be useful in the management of the exacerbation and should be performed in patients with frequent exacerbations, severe obstruction or exacerbations that require mechanical ventilation. The aim of the present study was to review the frequency with which sputum culture is requested in hospitalized COPD patients and to verify its usefulness in the management of exacerbations. Material and methods This is a one-year, retrospective, descriptive and analytical study of the patients admitted to our Pneumology Service between January 2017 to January 2018 with the diagnosis of exacerbated COPD. We collected demographic data, respiratory function, BODE severity index, exacerbations in the last year, and sputum culture. Results We studied 193 patients with a mean age of 71±10 years, a smoking index of 62.8±28.9 pack/year (72% ex-smokers) and 2.0±1.4 exacerbations per year. The mean FEV1 was 40±16% with a predominance of GOLD type 3. Of the total of hospitalized patients, cultures were requested in 122 (63%) being positive 44 (23%) and negative 78 (40%). Patients with positive cultures (23%) suffered more exacerbations in the year (2.6±1.9) than with negative cultures (2.0±1.3); p<0.029. We did not find significant differences when comparing age, FEV1, BODE index, smoking index or 6-minute walk test (6MWT). Regarding the type of cultivated bacteria, P. Aeruginosa was isolated in 25% of the cases, in the majority of the cases in severe COPD patients (91%). H. Influenzae in 27.3%, being 66% in severe patients. Conclusions In our hospitalized patients, sputum cultures were requested in more than half of them. P. Aeruginosa and H. Influenzae were the most common microorganisms among patients with severe and very severe COPD. Sputum cultures are more useful in patients with a history of frequent exacerbations.