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Importance of viral and bacterial infections in chronic obstructive pulmonary disease exacerbations.
J Clin Virol 2009; 46(2):129-33JC

Abstract

BACKGROUND

Few studies have evaluated the contribution of both viruses and bacteria in acute exacerbation of chronic obstructive pulmonary disease (AECOPD).

OBJECTIVES

This study estimated the burden of both types of pathogens among adults seeking care for an AECOPD during two consecutive winter seasons.

STUDY DESIGN

Patients 50 years or older who consulted within 10 days of AECOPD onset were eligible. Clinical data were collected on a standardized questionnaire, and nasopharyngeal aspirates (NPA), paired sera, and non-induced sputum were collected. Polymerase chain reaction (PRC) assays were used to identify viral, atypical and bacterial pathogens in NPA specimen.

RESULTS

Overall, 108 patients with AECOPD were included, 88% of patients were admitted and 2 patients (2%) received intensive care. A third of patients (31%) had evidence of a viral infection, 9% with influenza A, 7% RSV and 7% with PIV-3. One patient was positive for Mycoplasma pneumoniae. Bacterial pathogens were identified in 49% of patients with available sputum, most frequently Staphylococcus aureus, Pseudomonas aeruginosa, and Haemophilus influenzae. Among virus-infected patients, 14 (58%) also had bacteria in their sputum, but co-infected patients did not present with different symptoms than patients with single infections.

CONCLUSIONS

These results suggest that influenza and RSV are frequent contributors of AECOPD, and that coinfection with bacteria does not appear to be more severe among virus-infected patients. Clinicians should be aware that AECOPD may be frequently triggered by viruses, and may consider antivirals and proper infection control measures in appropriate epidemiological setting.

Authors+Show Affiliations

Institut national de santé publique du Québec, Québec (Québec), Canada. gaston.deserres@ssss.gouv.qc.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19665425

Citation

De Serres, Gaston, et al. "Importance of Viral and Bacterial Infections in Chronic Obstructive Pulmonary Disease Exacerbations." Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology, vol. 46, no. 2, 2009, pp. 129-33.
De Serres G, Lampron N, La Forge J, et al. Importance of viral and bacterial infections in chronic obstructive pulmonary disease exacerbations. J Clin Virol. 2009;46(2):129-33.
De Serres, G., Lampron, N., La Forge, J., Rouleau, I., Bourbeau, J., Weiss, K., ... Boivin, G. (2009). Importance of viral and bacterial infections in chronic obstructive pulmonary disease exacerbations. Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology, 46(2), pp. 129-33. doi:10.1016/j.jcv.2009.07.010.
De Serres G, et al. Importance of Viral and Bacterial Infections in Chronic Obstructive Pulmonary Disease Exacerbations. J Clin Virol. 2009;46(2):129-33. PubMed PMID: 19665425.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Importance of viral and bacterial infections in chronic obstructive pulmonary disease exacerbations. AU - De Serres,Gaston, AU - Lampron,Noël, AU - La Forge,Jacques, AU - Rouleau,Isabelle, AU - Bourbeau,Jean, AU - Weiss,Karl, AU - Barret,Béatrice, AU - Boivin,Guy, Y1 - 2009/08/07/ PY - 2009/03/03/received PY - 2009/07/10/revised PY - 2009/07/15/accepted PY - 2009/8/12/entrez PY - 2009/8/12/pubmed PY - 2009/12/23/medline SP - 129 EP - 33 JF - Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology JO - J. Clin. Virol. VL - 46 IS - 2 N2 - BACKGROUND: Few studies have evaluated the contribution of both viruses and bacteria in acute exacerbation of chronic obstructive pulmonary disease (AECOPD). OBJECTIVES: This study estimated the burden of both types of pathogens among adults seeking care for an AECOPD during two consecutive winter seasons. STUDY DESIGN: Patients 50 years or older who consulted within 10 days of AECOPD onset were eligible. Clinical data were collected on a standardized questionnaire, and nasopharyngeal aspirates (NPA), paired sera, and non-induced sputum were collected. Polymerase chain reaction (PRC) assays were used to identify viral, atypical and bacterial pathogens in NPA specimen. RESULTS: Overall, 108 patients with AECOPD were included, 88% of patients were admitted and 2 patients (2%) received intensive care. A third of patients (31%) had evidence of a viral infection, 9% with influenza A, 7% RSV and 7% with PIV-3. One patient was positive for Mycoplasma pneumoniae. Bacterial pathogens were identified in 49% of patients with available sputum, most frequently Staphylococcus aureus, Pseudomonas aeruginosa, and Haemophilus influenzae. Among virus-infected patients, 14 (58%) also had bacteria in their sputum, but co-infected patients did not present with different symptoms than patients with single infections. CONCLUSIONS: These results suggest that influenza and RSV are frequent contributors of AECOPD, and that coinfection with bacteria does not appear to be more severe among virus-infected patients. Clinicians should be aware that AECOPD may be frequently triggered by viruses, and may consider antivirals and proper infection control measures in appropriate epidemiological setting. SN - 1873-5967 UR - https://www.unboundmedicine.com/medline/citation/19665425/Importance_of_viral_and_bacterial_infections_in_chronic_obstructive_pulmonary_disease_exacerbations_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1386-6532(09)00362-X DB - PRIME DP - Unbound Medicine ER -