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The importance of bacterial and viral infections associated with adult asthma exacerbations in clinical practice.
PLoS One 2015; 10(4):e0123584Plos

Abstract

BACKGROUND

Viral infection is one of the risk factors for asthma exacerbation. However, which pathogens are related to asthma exacerbation in adults remains unclear.

OBJECTIVE

The relation between various infections and adult asthma exacerbations was investigated in clinical practice.

METHODS

The study subjects included 50 adult inpatients due to asthma exacerbations and 20 stable outpatients for comparison. The pathogens from a nasopharyngeal swab were measured by multiplex PCR analysis.

RESULTS

Asthma exacerbations occurred after a common cold in 48 inpatients. The numbers of patients with viral, bacterial, or both infections were 16, 9, and 9, respectively. The dominant viruses were rhinoviruses, respiratory syncytial virus, influenza virus, and metapneumovirus. The major bacteria were S. pneumoniae and H. influenzae. Compared to pathogen-free patients, the patients with pathogens were older and non-atopic and had later onset of disease, lower FeNO levels, lower IgE titers, and a higher incidence of comorbid sinusitis, COPD, or pneumonia. Compared to stable outpatients, asthma exacerbation inpatients had a higher incidence of smoking and comorbid sinusitis, COPD, or pneumonia. Viruses were detected in 50% of stable outpatients, but a higher incidence of rhinovirus, respiratory syncytial virus, and metapneumovirus infections was observed in asthma exacerbation inpatients. H. influenzae was observed in stable asthmatic patients. Other bacteria, especially S. pneumoniae, were important in asthma exacerbation inpatients.

CONCLUSION

Viral or bacterial infections were observed in 70% of inpatients with an asthma exacerbation in clinical practice. Infection with S. pneumoniae was related to adult asthma exacerbation.

Authors+Show Affiliations

Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.Laboratory of Systems Biology, Center for Experimental Medicine and Systems Biology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.Laboratory of Systems Biology, Center for Experimental Medicine and Systems Biology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan; Precursory Research for Embryonic Science and Technology, Japan Science and Technology Agency, Saitama, Japan.Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.

Pub Type(s)

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

Language

eng

PubMed ID

25901797

Citation

Iikura, Motoyasu, et al. "The Importance of Bacterial and Viral Infections Associated With Adult Asthma Exacerbations in Clinical Practice." PloS One, vol. 10, no. 4, 2015, pp. e0123584.
Iikura M, Hojo M, Koketsu R, et al. The importance of bacterial and viral infections associated with adult asthma exacerbations in clinical practice. PLoS ONE. 2015;10(4):e0123584.
Iikura, M., Hojo, M., Koketsu, R., Watanabe, S., Sato, A., Chino, H., ... Sugiyama, H. (2015). The importance of bacterial and viral infections associated with adult asthma exacerbations in clinical practice. PloS One, 10(4), pp. e0123584. doi:10.1371/journal.pone.0123584.
Iikura M, et al. The Importance of Bacterial and Viral Infections Associated With Adult Asthma Exacerbations in Clinical Practice. PLoS ONE. 2015;10(4):e0123584. PubMed PMID: 25901797.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The importance of bacterial and viral infections associated with adult asthma exacerbations in clinical practice. AU - Iikura,Motoyasu, AU - Hojo,Masayuki, AU - Koketsu,Rikiya, AU - Watanabe,Sho, AU - Sato,Ayano, AU - Chino,Haruka, AU - Ro,Shoki, AU - Masaki,Haruna, AU - Hirashima,Junko, AU - Ishii,Satoru, AU - Naka,Go, AU - Takasaki,Jin, AU - Izumi,Shinyu, AU - Kobayashi,Nobuyuki, AU - Yamaguchi,Sachiko, AU - Nakae,Susumu, AU - Sugiyama,Haruhito, Y1 - 2015/04/22/ PY - 2014/12/05/received PY - 2015/03/05/accepted PY - 2015/4/23/entrez PY - 2015/4/23/pubmed PY - 2016/1/20/medline SP - e0123584 EP - e0123584 JF - PloS one JO - PLoS ONE VL - 10 IS - 4 N2 - BACKGROUND: Viral infection is one of the risk factors for asthma exacerbation. However, which pathogens are related to asthma exacerbation in adults remains unclear. OBJECTIVE: The relation between various infections and adult asthma exacerbations was investigated in clinical practice. METHODS: The study subjects included 50 adult inpatients due to asthma exacerbations and 20 stable outpatients for comparison. The pathogens from a nasopharyngeal swab were measured by multiplex PCR analysis. RESULTS: Asthma exacerbations occurred after a common cold in 48 inpatients. The numbers of patients with viral, bacterial, or both infections were 16, 9, and 9, respectively. The dominant viruses were rhinoviruses, respiratory syncytial virus, influenza virus, and metapneumovirus. The major bacteria were S. pneumoniae and H. influenzae. Compared to pathogen-free patients, the patients with pathogens were older and non-atopic and had later onset of disease, lower FeNO levels, lower IgE titers, and a higher incidence of comorbid sinusitis, COPD, or pneumonia. Compared to stable outpatients, asthma exacerbation inpatients had a higher incidence of smoking and comorbid sinusitis, COPD, or pneumonia. Viruses were detected in 50% of stable outpatients, but a higher incidence of rhinovirus, respiratory syncytial virus, and metapneumovirus infections was observed in asthma exacerbation inpatients. H. influenzae was observed in stable asthmatic patients. Other bacteria, especially S. pneumoniae, were important in asthma exacerbation inpatients. CONCLUSION: Viral or bacterial infections were observed in 70% of inpatients with an asthma exacerbation in clinical practice. Infection with S. pneumoniae was related to adult asthma exacerbation. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/25901797/The_importance_of_bacterial_and_viral_infections_associated_with_adult_asthma_exacerbations_in_clinical_practice_ L2 - http://dx.plos.org/10.1371/journal.pone.0123584 DB - PRIME DP - Unbound Medicine ER -