Journal Article

Pathogens in COPD exacerbations identified by comprehensive real-time PCR plus older methods

Takasaka, Naoki, Kishi, Kazuma, Kuwano, Kazuyoshi, Kaneko, Yumi, Kojima, Jun, Shimizu, Kenichiro, Ubukata, Kimiko, Yoshii, Yutaka, Minagawa, Shunsuke, Hara, Hiromichi, Nakayama, Katsutoshi, Hanada, Shigeo, Araya, Jun, Uruga, Hironori, Kawaishi, Makoto, Saito, Nayuta, Wakui, Hiroshi, Numata, Takanori, Kadota, Tsukasa, Saito, Keisuke, Chiba, Naoko, Ito, Saburo, Morozumi, Miyuki

2015

Overview

Respiratory infection is a major cause of exacerbation in chronic obstructive pulmonary disease (COPD). Infectious contributions to exacerbations remain incompletely described. We therefore analyzed respiratory tract samples by comprehensive real-time polymerase chain reaction (PCR) in combination with conventional methods. We evaluated multiple risk factors for prolonged hospitalization to manage COPD exacerbations, including infectious agents. Over 19 months, we prospectively studied 46 patients with 50 COPD exacerbations, collecting nasopharyngeal swab and sputum samples from each. We carried out real-time PCR designed to detect six bacterial species and eleven viruses, together with conventional procedures, including sputum culture. Infectious etiologies of COPD exacerbations were identified in 44 of 50 exacerbations (88%). Infections were viral in 17 of 50 exacerbations (34%). COPD exacerbations caused by Gram-negative bacilli, including enteric and nonfermenting organisms, were significantly associated with prolonged hospitalization for COPD exacerbations. Our results support the use of a combination of real-time PCR and conventional methods for determining both infectious etiologies and risk of extended hospitalization.

• Publisher: Dove Medical Press Limited,Dove Medical Press Ltd,Dove Medical Press
• Subject: Aged / Aged, 80 and over / Bacterial infections / Causes of / Chronic obstructive pulmonary disease / Development and progression / Diagnosis / Disease Progression / Female / Genetic aspects / Health aspects / Hospitalization / Humans / Influenza / Lung diseases, Obstructive / Male / Methods / Middle Aged / Original Research / Pathogenic microorganisms / Physiological aspects / Polymerase chain reaction / Prospective Studies / Pulmonary Disease, Chronic Obstructive - complications / Real-Time Polymerase Chain Reaction - methods / Respiratory syncytial virus / Respiratory Tract Infections - etiology / Respiratory Tract Infections - microbiology / Risk Factors / Sputum - microbiology / Viral infections / Viruses