Quantitative analysis of pathogens in the lower respiratory tract of patients with chronic obstructive pulmonary disease.
BACKGROUND
Bacterial infection of the lower respiratory tract is believed to play a major role in the pathogenesis of chronic obstructive pulmonary disease (COPD) and acute exacerbations of COPD (AECOPD). This study investigates the potential relationship between AECOPD and the load of six common bacterial pathogens in the lower respiratory tract using real-time quantitative PCR (RT-qPCR) in COPD patients.


METHODS
Protected specimen brush (PSB) and bronchoalveolar lavage fluid (BALF) samples from the lower respiratory tract of 66 COPD patients and 33 healthy subjects were collected by bronchoscopy. The load of Staphylococcus aureus, Klebsiella pneumoniae, Streptococcus pneumoniae, Pseudomonos aeruginosa, Haemophilus influenzeae, and Moraxella catarrhalis were detected by RT-qPCR.


RESULTS
High Klebsiella pneumoniae, Pseudomonos aeruginosa, Haemophilus influenzeae and Moraxella catarrhalis burden were detected by RT-qPCR in both PSB and BALF samples obtained from stable COPD and AECOPD patients compared with healthy subjects. The load of the above four pathogenic strains in PSB and BALF samples obtained from AECOPD patients were significantly higher compared with stable COPD patients. Finally, positive correlations between bacterial loads and inflammatory mediators such as neutrophil count and cytokine levels of IL-1β, IL-6 and IL-8, as well as negative correlations between bacterial loads and the forced expiratory volume in one second (FEV1) % predicted, forced vital capacity (FVC) % predicted, and FEV1/FVC ratio, were detected.


CONCLUSIONS
These findings suggest that increased bacterial loads mediated inflammatory response in the lower respiratory tract and were associated with AECOPD. In addition, these results provide guidance for antibiotic therapy of AECOPD patients.
Department of Respiratory Diseases, Affiliated Yinzhou Hospital, College of Medicine, Ningbo University, 251 East Baizhang Road, Ningbo City, Zhejiang Province, 315040, P. R. China.
Huaying
H
Wang
Department of Respiratory Diseases, Affiliated Yinzhou Hospital, College of Medicine, Ningbo University, 251 East Baizhang Road, Ningbo City, Zhejiang Province, 315040, P. R. China.
Xiao
X
Gu
Clinical Laboratory, First Hospital, 58 Liuting Road, Ningbo City, Zhejiang Province, 315010, P. R. China.
Yuesong
Y
Weng
Department of Respiratory Diseases, Affiliated Yinzhou Hospital, College of Medicine, Ningbo University, 251 East Baizhang Road, Ningbo City, Zhejiang Province, 315040, P. R. China.
Tao
T
Xu
Department of Respiratory Diseases, Affiliated Yinzhou Hospital, College of Medicine, Ningbo University, 251 East Baizhang Road, Ningbo City, Zhejiang Province, 315040, P. R. China.
Zhongming
Z
Fu
Department of Respiratory Diseases, Affiliated Yinzhou Hospital, College of Medicine, Ningbo University, 251 East Baizhang Road, Ningbo City, Zhejiang Province, 315040, P. R. China.
Weidong
W
Peng
Department of Respiratory Diseases, Affiliated Yinzhou Hospital, College of Medicine, Ningbo University, 251 East Baizhang Road, Ningbo City, Zhejiang Province, 315040, P. R. China. nbyuwanjun@163.com.
Wanjun
W
Yu
D000368:Aged; D001419:Bacteria / Q000235:genetics / Q000302:isolation & purification*; D001424:Bacterial Infections / Q000150:complications / Q000382:microbiology*; D001980:Bronchi / Q000382:microbiology*; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology*; D004269:DNA, Bacterial / Q000032:analysis*; D005260:Female; D006801:Humans; D008297:Male; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000382:microbiology / Q000503:physiopathology; D060888:Real-Time Polymerase Chain Reaction; D012189:Retrospective Studies
D004269:DNA, Bacterial