PP14 PATTERNS OF RESPIRATORY PATHOGENS AND THEIR ASSOCIATION WITH LENGTH OF HOSPITAL STAY AND CLINICAL OUTCOMES IN PATIENTS WITH ACUTE EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Shu Qing Sim, Nicholas Jian Shen Ng, Chiong Kian Tiong, Jun Xuan Lee, Jonathan Jian Yao Ng, Felicia En Min Koh, Mifzal Al Khair Musab Al Khair, Chee Kuan Wong

Universiti Malaya, Kuala Lumpur, Malaysia.

Introduction
Respiratory infection is a major trigger for acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Studies have shown that 60–80% of these exacerbations are caused by bacterial or respiratory viral infections. However, data on local respiratory pathogens and their impact on clinical outcomes, such as 30-day readmission, mortality, and length of hospital stay, remain limited.

Objectives
To describe the prevalence of bacterial, viral, and bacterial-viral co-infections among patients with severe AECOPD and their associated clinical outcomes.

Methodology
A retrospective observational study was conducted at a tertiary care centre in Malaysia, involving patients admitted for severe AECOPD from June 2024 to April 2025. Respiratory and blood specimens were analysed for bacterial, viral, fungal, and other pathogens using culture and multiplex PCR. Patients’ demographics, clinical parameters, and outcomes were extracted from medical records.

Results
Among 128 COPD admissions, 58 patients (45.3%) had pathogens identified in their respiratory and/or blood specimens. Bacterial infection was the most common (36 patients, 62.1%), followed by viral infection (11 patients, 19%), bacterial-viral co-infection (7 patients, 12.1%), and fungal infection (4 patients, 6.9%). Among patients with identified bacterial pathogens, 6 patients (10.3%) experienced 30-day readmission, and 2 patients (3.4%) died. However, there was no statistically significant association between the type of pathogens identified and either the length of hospital stay (p = 0.153) or 30-day readmission (p = 0.729).

Conclusions
Bacterial and viral infections are important triggers of COPD exacerbation. These findings highlight the importance of pathogen identification to guide targeted antibiotic therapy and optimize patient management. Further prospective studies are warranted to better define the impact of specific pathogens on clinical outcomes in this population.