title: Infectious exacerbations of chronic obstructive pulmonary disease associated with respiratory viruses and non-typeable Haemophilus influenzae.
abstract: Infectious exacerbations of chronic obstructive pulmonary disease (COPD) have been reported to occur with both viral and bacterial pathogens. In this study, 35 exacerbations associated with the isolation of non-typeable Haemophilus influenzae from sputum were identified as part of a prospective longitudinal study. Samples from these patients were subjected to immunoassays to identify a new immune response to the homologous isolate of non-typeable H. influenzae to more accurately assess a bacterial etiology. These patients also were studied carefully for evidence of viral infection using viral culture, serology and polymerase chain reaction-based assays. Sixteen of 35 exacerbations (45.7%) were associated with evidence of acute viral infection and 11 of the 35 exacerbations (31.4%) were associated with the development of new serum IgG to homologous non-typeable H. influenzae. Overall, evidence of infection with a respiratory virus or non-typeable H. influenzae was seen in 24 of 35 exacerbations (68.6%). No association between viral infection and immune response to non-typeable H. influenzae was observed, although a trend toward an immune response to non-typeable H. influenzae and absence of viral infection was seen. The results show that exacerbations in adults with COPD were associated with infection caused by virus alone, non-typeable H. influenzae alone, or virus and non-typeable H. influenzae simultaneously.
authors.affiliation: Section of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Venkata
authors.initials: V
authors.lastname: Bandi
authors.forename: Marta
authors.initials: M
authors.lastname: Jakubowycz
authors.forename: Carla
authors.initials: C
authors.lastname: Kinyon
authors.forename: Edward O
authors.initials: EO
authors.lastname: Mason
authors.forename: Robert L
authors.initials: RL
authors.lastname: Atmar
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Greenberg
authors.forename: Timothy F
authors.initials: TF
authors.lastname: Murphy
mesh_terms: D000907:Antibodies, Bacterial / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006192:Haemophilus Infections / Q000276:immunology / Q000382:microbiology; D006193:Haemophilus influenzae / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*; D012141:Respiratory Tract Infections / Q000382:microbiology* / Q000821:virology*; D013183:Sputum / Q000382:microbiology / Q000821:virology; D014777:Virus Diseases / Q000821:virology*; D014780:Viruses / Q000145:classification / Q000302:isolation & purification
chemical_list: D000907:Antibodies, Bacterial; D007074:Immunoglobulin G