Bacterial infection in Tunisian patients admitted to the emergency room for exacerbation of chronic obstructive pulmonary disease: role of acute Chlamydophila pneumoniae infection

To investigate the frequency of respiratory bacterial infections included the role of atypical bacteria such as Chlamydophila pneumoniae and Mycoplasma pneumonia in hospitalized patients admitted to the emergency room for an acute episode of chronic obstructive pulmonary disease (COPD). Prospective observational study conducted on 50 consecutive patients. Serum specimens were collected at days 0 and 15. C. pneumoniae and M pneumoniae antibodies (IgM and IgG) were tested by commercial ELISA and immunofluorescence assay, respectively. At least one sample of spontaneously expectorated sputum for microbiologic evaluation was obtained in all patients during admission. No acute M. pneumoniae infection was recorded; by contrast 7 patients (14%) showed a profile compatible with a recent C. pneumoniae infection. Demographic and clinical parameters did not differ between patients with and without stigmata of recent C. pneumoniae infection. Eleven patients (22%) had positive sputum cultures, indicating the presence of bacterial infection. Pathogens most frequently isolated were: Pseudomonas aeruginosa (n=4), Haemophilus influenzae (n=2), and Klebsiella pneumoniae (n=2).