2021, Vol. 3, Issue 2, Part I

Objective: Chronic obstructive pulmonary disease (COPD)- exacerbation have a significant mortality impact. Exacerbations are severe and frequent as the severity of copd increases. Predicting a bacterial cause of an exacerbation of COPD is difficult. C-reactive protein (CRP) levels increase during exacerbations but the relationship with etiology is not established. We aimed to explore the relationship between levels of CRP and various microorganisms responsible for infective exacerbation.

Methods: In this study, patient serum was obtained and C-reactive protein (CRP) levels were measured using an automated latex-enhanced turbidimetric assay. Sputum samples were obtained and evaluated microscopically. Episodes of exacerbations meeting Anthonisen’s criteria type I–II were evaluated, analyzing the etiology and inflammatory response as measured by CRP in blood. The relationship between CRP and the bacterial colonies in sputum/blood in 92 patients with an exacerbation of COPD was assessed. Results categorized according to the etiology of sepsis (gram negative or gram positive) were also compared.

Results: A total of 92 patients were examined, Full microbiology analysis was available in 90 samples. Klebsiella pneumonia (27) and staphylococcus arues (14) were the most common gram negative and gram positive organism isolated respectively. Median CRP levels were 46.56(IQR – 15.38 – 95.08). Univariate and multivariate logistic regression analysis showed that High CRP levels were associated with male gender, elderly population, longer disease duration and prolonged hospital stay, and these factors were found to be statistically significant.

Conclusion: CRP levels were higher in gram positive infections when compared to gram negative infections. High CRP levels can be used as biomarker for prediction bacterial exacerbation.