A Multicenter Study to Identify the Respiratory Pathogens Associated with Exacerbation of Chronic Obstructive Pulmonary Disease in Korea

Tuberculosis and Respiratory Diseases

article

Hyun Woo Lee¹  Yun Su Sim²  Ji Ye Jung³  Hyewon Seo⁴  Jeong-Woong Park⁵  Kyung Hoon Min⁶  Jae Ha Lee⁷  Byung-Keun Kim⁸  Myung Goo Lee⁹  Yeon-Mok Oh^1,10  Seung Won Ra^1,11  Tae-Hyung Kim^1,12  Yong il Hwang^1,13  Chin Kook Rhee^1,14  Hyonsoo Joo^1,15  Eung Gu Lee^1,16  Jin Hwa Lee^1,17  Hye Yun Park^1,18  Woo Jin Kim^1,19  Soo-Jung Um^2,20  Joon Young Choi^2,21  Chang-Hoon Lee^2,22  Tai Joon An^2,23  Yeonhee Park^2,24  Young-Soon Yoon^2,25  Joo Hun Park^2,26  Kwang Ha Yoo^2,27  Deog Kyeom Kim¹ 

[1] Division 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;Division of Pulmonary, Allergy and Critical Care Medicine, Kangnam Sacred Heart Hospital;Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine;Department of Internal Medicine, School of Medicine, Kyungpook National University Hospital;Department of Internal Medicine, Gachon University Gil Medical Center, Incheon;Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine;Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine;Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine;Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine;Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine;Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine;Division of Pulmonary and Critical Care Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine;Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine;Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea;Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea;Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea;Department of Internal Medicine, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine;Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine;Department of Internal Medicine and Environmental Health Center, Kangwon National University College of Medicine;Department of Internal Medicine, Dong-A University College of Medicine;Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea;Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital;Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea;Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea;Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Dongguk University Ilsan Hospital;Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine;Department of Internal Medicine, Konkuk University School of Medicine

关键词: Symptom Flare Up;    Pulmonary Disease;    Chronic Obstructive;    Microbiology;    Bacteriology;    Virology;   

DOI  :  10.4046/trd.2021.0080

学科分类：医学（综合）

来源: The Korean Academy of Tuberculosis and Respiratory Diseases

【 摘 要 】

BackgroundAlthough respiratory tract infection is one of the most important factors triggering acute exacerbation of chronic obstructive pulmonary disease (AE-COPD), limited data are available to suggest an epidemiologic pattern of microbiology in South Korea. MethodsA multicenter observational study was conducted between January 2015 and December 2018 across 28 hospitals in South Korea. Adult patients with moderate-to-severe acute exacerbations of COPD were eligible to participate in the present study. The participants underwent all conventional tests to identify etiology of microbial pathogenesis. The primary outcome was the percentage of different microbiological pathogens causing AE-COPD. A comparative microbiological analysis of the patients with overlapping asthma-COPD (ACO) and pure COPD was performed. ResultsWe included 1,186 patients with AE-COPD. Patients with pure COPD constituted 87.9% and those with ACO accounted for 12.1%. Nearly half of the patients used an inhaled corticosteroid-containing regimen and one-fifth used systemic corticosteroids. Respiratory pathogens were found in 55.3% of all such patients. Bacteria and viruses were detected in 33% and 33.2%, respectively. Bacterial and viral coinfections were found in 10.9%. The most frequently detected bacteria were Pseudomonas aeruginosa (9.8%), and the most frequently detected virus was influenza A (10.4%). Multiple bacterial infections were more likely to appear in ACO than in pure COPD (8.3% vs. 3.6%, p=0.016). ConclusionDistinct microbiological patterns were identified in patients with moderate-to-severe AE-COPD in South Korea. These findings may improve evidence-based management of patients with AE-COPD and represent the basis for further studies investigating infectious pathogens in patients with COPD.

【 授权许可】

CC BY-NC