| Clinical significance of various pathogens identified in patients with acute exacerbations of COPD: a multi-center study in South Korea |
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Hyun Woo Ji1, Soojoung Yu2, Yun Su Sim3, Hyewon Seo4, Jeong-Woong Park5, Kyung Hoon Min6, Deog Kyeom Kim7, Hyun Woo Lee7, Chin Kook Rhee8, Yong Bum Park9, Kyeong-Cheol Shin10, Kwang Ha Yoo11, Ji Ye Jung1 |
1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
2International Healthcare Center, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea
3Division of Pulmonary, Allergy and Critical Care Medicine, Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
4Department of Internal Medicine, School of Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
5Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
6Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
7Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
8Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
9Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Republic of Korea
10Division of Pulmonology and Allergy, Department of Internal Medicine, Yeungnam University Medical Center, College of Medicine, Yeungnam University, Daegu, Republic of Korea
11Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea |
Correspondence:
Kwang Ha Yoo, Tel: 82-2-2030-7522, Fax: 82-2-2030-7458,
Email: khyou@kuh.ac.kr
Ji Ye Jung, Tel: 82-10-3141-2576, Fax: 82-2-2227-8294,
Email: stopyes@yuhs.ac
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Received: 4 July 2024 • Revised: 22 October 2024 • Accepted: 16 December 2024 |
| Abstract |
Background
Respiratory infection is a major cause of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). We investigated the presence of bacterial and viral pathogens and clinical features in patients with AECOPD.
Methods
This retrospective study included 1,186 patients diagnosed with AECOPD from 28 hospitals in South Korea between 2015–2018. Pathogen identification rates, basic characteristics and clinical features, and associated factors for infection with potentially drug-resistant (PDR) pathogens were evaluated using microbiological tests.
Results
Bacteria, viruses, and both were found in 262 (22.1%), 265 (22.5%), and 129 (10.9%) patients, respectively. The most common pathogens were Pseudomonas aeruginosa (17.8%), Mycoplasma pneumoniae (11.2%), Streptococcus pneumoniae (9.0%), influenza A virus (19.0%), rhinovirus (15.8%), and respiratory syncytial virus (6.4%). A history of pulmonary tuberculosis (OR 1.66; P=0.046), bronchiectasis (OR 1.99; P=0.032), and triple inhaler use within six months (OR 2.04; P=0.005) were significant associated factors for PDR pathogen infection. Hospital stay length (15.9 days vs. 12.4 days; P=0.018) and ICU admission rates (15.9% vs. 9.5%; P=0.030) were increased in patients infected with PDR pathogens.
Conclusions
This study indicates that various types of pathogens are implicated during AECOPD. However, further research is needed to confirm whether these pathogens influence AECOPD development and progression. |
| Key Words:
chronic obstructive pulmonary disease, acute exacerbation, pathogen, drug resistance |
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