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Bacterial colonization increases daily symptoms in patients with chronic obstructive pulmonary disease.
Ann Am Thorac Soc 2014; 11(3):303-9AA

Abstract

RATIONALE

Respiratory pathogens are frequently isolated from the airways of patients with chronic obstructive pulmonary disease (COPD) in the absence of an exacerbation. This bacterial "colonization" by potential pathogens is associated with host inflammatory and immune responses, which could increase respiratory symptoms.

OBJECTIVES

To study whether bacterial colonization impacts daily respiratory symptoms in COPD.

METHODS

In a longitudinal prospective observational study of COPD, patients recorded daily symptoms electronically on the Breathlessness, Cough, and Sputum Scale (BCSS). Sputum cultures and quantitative polymerase chain reaction (PCR) were performed every 2 weeks. The relationship of BCSS and bacterial colonization was analyzed with generalized linear mixed effects models, after controlling for exacerbations, weather conditions, lung function, and demographic variables.

MEASUREMENTS AND MAIN RESULTS

A total of 41 patients recorded daily symptoms for 12,527 days. The average BCSS score was higher during the periods of colonization, determined by sputum culture with one or more of the following pathogens: nontypeable Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae, and Pseudomonas aeruginosa, compared to periods without colonization (5.28 vs. 4.46; P = 0.008) after controlling for confounding variables. The finding did not change when colonization was defined by quantitative PCR (average BCSS, 4.77 vs. 4.25; P = 0.006). Sputum IL-8 levels were elevated with bacterial colonization.

CONCLUSIONS

Even in the absence of clinical exacerbation, colonization by bacterial pathogens in COPD was associated with a clinically significant moderate increase in daily symptoms, likely mediated by increased airway inflammation. Novel therapies that decrease bacterial colonization in COPD could improve daily symptoms and quality of life.

Authors+Show Affiliations

1 Chesapeake Pulmonary and Critical Care Medicine, Chesapeake, Virginia.No affiliation info availableNo affiliation info availableNo 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, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

24423399

Citation

Desai, Himanshu, et al. "Bacterial Colonization Increases Daily Symptoms in Patients With Chronic Obstructive Pulmonary Disease." Annals of the American Thoracic Society, vol. 11, no. 3, 2014, pp. 303-9.
Desai H, Eschberger K, Wrona C, et al. Bacterial colonization increases daily symptoms in patients with chronic obstructive pulmonary disease. Ann Am Thorac Soc. 2014;11(3):303-9.
Desai, H., Eschberger, K., Wrona, C., Grove, L., Agrawal, A., Grant, B., ... Sethi, S. (2014). Bacterial colonization increases daily symptoms in patients with chronic obstructive pulmonary disease. Annals of the American Thoracic Society, 11(3), pp. 303-9. doi:10.1513/AnnalsATS.201310-350OC.
Desai H, et al. Bacterial Colonization Increases Daily Symptoms in Patients With Chronic Obstructive Pulmonary Disease. Ann Am Thorac Soc. 2014;11(3):303-9. PubMed PMID: 24423399.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bacterial colonization increases daily symptoms in patients with chronic obstructive pulmonary disease. AU - Desai,Himanshu, AU - Eschberger,Karen, AU - Wrona,Catherine, AU - Grove,Lori, AU - Agrawal,Aarti, AU - Grant,Brydon, AU - Yin,Jingjing, AU - Parameswaran,G Iyer, AU - Murphy,Timothy, AU - Sethi,Sanjay, PY - 2014/1/16/entrez PY - 2014/1/16/pubmed PY - 2014/12/17/medline SP - 303 EP - 9 JF - Annals of the American Thoracic Society JO - Ann Am Thorac Soc VL - 11 IS - 3 N2 - RATIONALE: Respiratory pathogens are frequently isolated from the airways of patients with chronic obstructive pulmonary disease (COPD) in the absence of an exacerbation. This bacterial "colonization" by potential pathogens is associated with host inflammatory and immune responses, which could increase respiratory symptoms. OBJECTIVES: To study whether bacterial colonization impacts daily respiratory symptoms in COPD. METHODS: In a longitudinal prospective observational study of COPD, patients recorded daily symptoms electronically on the Breathlessness, Cough, and Sputum Scale (BCSS). Sputum cultures and quantitative polymerase chain reaction (PCR) were performed every 2 weeks. The relationship of BCSS and bacterial colonization was analyzed with generalized linear mixed effects models, after controlling for exacerbations, weather conditions, lung function, and demographic variables. MEASUREMENTS AND MAIN RESULTS: A total of 41 patients recorded daily symptoms for 12,527 days. The average BCSS score was higher during the periods of colonization, determined by sputum culture with one or more of the following pathogens: nontypeable Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae, and Pseudomonas aeruginosa, compared to periods without colonization (5.28 vs. 4.46; P = 0.008) after controlling for confounding variables. The finding did not change when colonization was defined by quantitative PCR (average BCSS, 4.77 vs. 4.25; P = 0.006). Sputum IL-8 levels were elevated with bacterial colonization. CONCLUSIONS: Even in the absence of clinical exacerbation, colonization by bacterial pathogens in COPD was associated with a clinically significant moderate increase in daily symptoms, likely mediated by increased airway inflammation. Novel therapies that decrease bacterial colonization in COPD could improve daily symptoms and quality of life. SN - 2325-6621 UR - https://www.unboundmedicine.com/medline/citation/24423399/Bacterial_colonization_increases_daily_symptoms_in_patients_with_chronic_obstructive_pulmonary_disease_ L2 - http://www.atsjournals.org/doi/full/10.1513/AnnalsATS.201310-350OC?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -