title: Respiratory infectious phenotypes in acute exacerbation of COPD: an aid to length of stay and COPD Assessment Test.
abstract: OBJECTIVE
  To investigate the respiratory infectious phenotypes and their impact on length of stay (LOS) and the COPD Assessment Test (CAT) Scale in acute exacerbation of COPD (AECOPD).
  
  
  METHODS
  We categorized 81 eligible patients into bacterial infection, viral infection, coinfection, and non-infectious groups. The respiratory virus examination was determined by a liquid bead array xTAG Respiratory Virus Panel in pharyngeal swabs, while bacterial infection was studied by conventional sputum culture. LOS and CAT as well as demographic information were recorded.
  
  
  RESULTS
  Viruses were detected in 38 subjects, bacteria in 17, and of these, seven had both. Influenza virus was the most frequently isolated virus, followed by enterovirus/rhinovirus, coronavirus, bocavirus, metapneumovirus, parainfluenza virus types 1, 2, 3, and 4, and respiratory syncytial virus. Bacteriologic analyses of sputum showed that Pseudomonas aeruginosa was the most common bacteria, followed by Acinetobacter baumannii, Klebsiella, Escherichia coli, and Streptococcus pneumoniae. The longest LOS and the highest CAT score were detected in coinfection group. CAT score was positively correlated with LOS.
  
  
  CONCLUSIONS
  Respiratory infection is a common causative agent of exacerbations in COPD. Respiratory coinfection is likely to be a determinant of more severe acute exacerbations with longer LOS. CAT score may be a predictor of longer LOS in AECOPD.
authors.affiliation: Pulmonary Department, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.
authors.forename: Meng-Yuan
authors.initials: MY
authors.lastname: Dai
authors.affiliation: Department of Clinical Laboratory, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.
authors.forename: Jin-Ping
authors.initials: JP
authors.lastname: Qiao
authors.affiliation: Department of Clinical Laboratory, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.
authors.forename: Yuan-Hong
authors.initials: YH
authors.lastname: Xu
authors.affiliation: Pulmonary Department, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.
authors.forename: Guang-He
authors.initials: GH
authors.lastname: Fei
mesh_terms: D000368:Aged; D001419:Bacteria / Q000145:classification / Q000302:isolation & purification; D001424:Bacterial Infections / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology / Q000503:physiopathology; D012129:Respiratory Function Tests / Q000379:methods; D012141:Respiratory Tract Infections / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D012720:Severity of Illness Index; D013183:Sputum / Q000382:microbiology; D000067251:Symptom Flare Up
keywords: CAT; COPD; LOS; acute exacerbation; phenotypes; respiratory infectious