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Viral and bacterial infection in acute asthma and chronic obstructive pulmonary disease increases the risk of readmission.
Respirology 2013; 18(6):996-1002R

Abstract

BACKGROUND AND OBJECTIVE

Infection is as an important trigger for acute asthma and chronic obstructive pulmonary disease (COPD). The aim of this article was to determine the prevalence and impact of virus and bacterial infections in acute asthma and COPD.

METHODS

Subjects were recruited, within 24 h of hospital admission for acute exacerbations of asthma and COPD. Nose/throat swabs and sputum samples were collected and examined by multiplex polymerase chain reaction for respiratory viruses and cultured for bacteria. The primary outcomes were length of stay (LOS) and readmission to hospital within 60 days.

RESULTS

A total of 199 subjects were recruited (96 had asthma and 103 COPD) for 235 events (36 re-presented). A virus was detected in 79 subjects (40%), bacteria in 41 (21%), and of these, 18 had both. Rhinovirus A was the most frequently isolated virus. A multivariate analysis was performed to control for confounders. It found that detection of a virus, a virus and bacteria, forced expiratory volume in 1 s (FEV(1)) and a diagnosis of COPD were all independent predictors of prolonged LOS, while risk of readmission within 60 days was increased with virus infection alone, virus and bacterial infection, lower FEV(1) and current smoking.

CONCLUSIONS

Virus infection, especially in the presence of chronic bacterial infection, is an important determinant of more severe acute exacerbations in both asthma and COPD, and patients with co-infections are more likely to be readmitted to hospital following their exacerbation.

Authors+Show Affiliations

Centre for Asthma and Respiratory Disease, University of Newcastle, Newcastle, New South Wales, Australia. peter.wark@hnehealth.nsw.gov.auNo 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

23600594

Citation

Wark, Peter A B., et al. "Viral and Bacterial Infection in Acute Asthma and Chronic Obstructive Pulmonary Disease Increases the Risk of Readmission." Respirology (Carlton, Vic.), vol. 18, no. 6, 2013, pp. 996-1002.
Wark PA, Tooze M, Powell H, et al. Viral and bacterial infection in acute asthma and chronic obstructive pulmonary disease increases the risk of readmission. Respirology. 2013;18(6):996-1002.
Wark, P. A., Tooze, M., Powell, H., & Parsons, K. (2013). Viral and bacterial infection in acute asthma and chronic obstructive pulmonary disease increases the risk of readmission. Respirology (Carlton, Vic.), 18(6), pp. 996-1002. doi:10.1111/resp.12099.
Wark PA, et al. Viral and Bacterial Infection in Acute Asthma and Chronic Obstructive Pulmonary Disease Increases the Risk of Readmission. Respirology. 2013;18(6):996-1002. PubMed PMID: 23600594.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Viral and bacterial infection in acute asthma and chronic obstructive pulmonary disease increases the risk of readmission. AU - Wark,Peter A B, AU - Tooze,Melinda, AU - Powell,Heather, AU - Parsons,Kristy, PY - 2012/09/12/received PY - 2012/11/22/revised PY - 2012/12/26/revised PY - 2013/01/22/accepted PY - 2013/4/23/entrez PY - 2013/4/23/pubmed PY - 2014/5/28/medline KW - asthma KW - chronic obstructive pulmonary disease KW - infection and inflammation KW - respiratory infection KW - viral infection SP - 996 EP - 1002 JF - Respirology (Carlton, Vic.) JO - Respirology VL - 18 IS - 6 N2 - BACKGROUND AND OBJECTIVE: Infection is as an important trigger for acute asthma and chronic obstructive pulmonary disease (COPD). The aim of this article was to determine the prevalence and impact of virus and bacterial infections in acute asthma and COPD. METHODS: Subjects were recruited, within 24 h of hospital admission for acute exacerbations of asthma and COPD. Nose/throat swabs and sputum samples were collected and examined by multiplex polymerase chain reaction for respiratory viruses and cultured for bacteria. The primary outcomes were length of stay (LOS) and readmission to hospital within 60 days. RESULTS: A total of 199 subjects were recruited (96 had asthma and 103 COPD) for 235 events (36 re-presented). A virus was detected in 79 subjects (40%), bacteria in 41 (21%), and of these, 18 had both. Rhinovirus A was the most frequently isolated virus. A multivariate analysis was performed to control for confounders. It found that detection of a virus, a virus and bacteria, forced expiratory volume in 1 s (FEV(1)) and a diagnosis of COPD were all independent predictors of prolonged LOS, while risk of readmission within 60 days was increased with virus infection alone, virus and bacterial infection, lower FEV(1) and current smoking. CONCLUSIONS: Virus infection, especially in the presence of chronic bacterial infection, is an important determinant of more severe acute exacerbations in both asthma and COPD, and patients with co-infections are more likely to be readmitted to hospital following their exacerbation. SN - 1440-1843 UR - https://www.unboundmedicine.com/medline/citation/23600594/Viral_and_bacterial_infection_in_acute_asthma_and_chronic_obstructive_pulmonary_disease_increases_the_risk_of_readmission_ L2 - https://doi.org/10.1111/resp.12099 DB - PRIME DP - Unbound Medicine ER -