title: Detection of multiple viral and bacterial infections in acute exacerbation of chronic obstructive pulmonary disease: a pilot prospective study.
abstract: Few studies have evaluated the contribution of multiple virus and bacterial infections in acute exacerbation of chronic obstructive pulmonary disease. This study estimated the burden of multiple viral and bacterial respiratory infections in moderate to very severe chronic obstructive pulmonary disease patients that were prospectively followed-up during a 12-month pilot study. Clinical data were collected monthly and sputum was collected at the time of each acute exacerbation event. Classical culture techniques for bacteria and multiplex polymerase chain reaction (PCR) and microarray detection assays were performed to identify viral and atypical bacterial pathogens in the sputum. Overall, 51 patients were included and 45 acute exacerbation events were investigated clinically and microbiologically. Among the 45 acute exacerbation events, 44% had evidence of viral infection involving human rhinovirus (HRV) and metapneumovirus (hMPV) in 20% and 18%, respectively. Intracellular bacteria were not found in sputum by PCR. Common bacterial pathogens were identified in 42% of acute exacerbation patients, most frequently Branhamella catarrhalis, Streptococcus pneumoniae and Haemophilus influenzae. Viral or virus and bacteria co-infections were detected in 27% of acute exacerbation events (n = 12) with HRV and hMPV involved in 92% of cases. Patients with co-infections did not present greater clinical severity scores at exacerbation and more recurrence of acute exacerbation events at 3 and 6 months than those with single infections (P > 0.4). These results suggest that HRV and hMPV may be contributors or cofactors of AECOPD. These findings indicate that viral or virus and bacterial co-infections do not impact significantly on the clinical severity of acute exacerbation of chronic obstructive pulmonary disease and recurrence at 3 and 6 months.
authors: Department of Respiratory Medicine, INSERM UMRS 903, University Hospital of Reims, France. jmperotin-collard@chu-reims.fr
authors: Jeanne-Marie
authors: JM
authors: Perotin
authors: Sandra
authors: S
authors: Dury
authors: Fanny
authors: F
authors: Renois
authors: Gaëtan
authors: G
authors: Deslee
authors: Aurore
authors: A
authors: Wolak
authors: Véronique
authors: V
authors: Duval
authors: Christophe
authors: C
authors: De Champs
authors: François
authors: F
authors: Lebargy
authors: Laurent
authors: L
authors: Andreoletti
mesh_terms: D000368:Aged; D001419:Bacteria / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D001996:Bronchopneumonia / Q000453:epidemiology* / Q000382:microbiology / Q000821:virology; D019411:Clinical Laboratory Techniques / Q000379:methods; D060085:Coinfection / Q000453:epidemiology / Q000382:microbiology / Q000821:virology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques / Q000379:methods; D008969:Molecular Sequence Data; D018410:Pneumonia, Bacterial / Q000453:epidemiology* / Q000382:microbiology; D011024:Pneumonia, Viral / Q000453:epidemiology* / Q000821:virology; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*; D017422:Sequence Analysis, DNA; D013183:Sputum / Q000382:microbiology / Q000821:virology; D014780:Viruses / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*