Abstract | RATIONALE: OBJECTIVES: We investigated whether COPD exacerbations requiring hospitalization are associated with viral and/or bacterial infection and evaluated relationships among infection, exacerbation severity, assessed by reduction of FEV1, and specific patterns of airway inflammation. METHODS: RESULTS: Exacerbations were associated with impaired lung function (p < 0.01) and increased sputum neutrophilia (p < 0.001). Viral and/or bacterial infection was detected in 78% of exacerbations: viruses in 48.4% (6.2% when stable, p < 0.001) and bacteria in 54.7% (37.5% when stable, p = 0.08). Patients with infectious exacerbations (29.7% bacterial, 23.4% viral, 25% viral/bacterial coinfection) had longer hospitalizations (p < 0.02) and greater impairment of several measures of lung function (all p < 0.05) than those with noninfectious exacerbations. Patients with exacerbations with coinfection had more marked lung function impairment (p < 0.02) and longer hospitalizations (p = 0.001). Sputum neutrophils were increased in all exacerbations (p < 0.001) and were related to their severity (p < 0.001), independently of the association with viral or bacterial infections; sputum eosinophils were increased during (p < 0.001) virus-associated exacerbations. CONCLUSIONS:
|
Authors | Alberto Papi, Cinzia Maria Bellettato, Fausto Braccioni, Micaela Romagnoli, Paolo Casolari, Gaetano Caramori, Leonardo M Fabbri, Sebastian L Johnston |
Journal | American journal of respiratory and critical care medicine
(Am J Respir Crit Care Med)
Vol. 173
Issue 10
Pg. 1114-21
(May 15 2006)
ISSN: 1073-449X [Print] United States |
PMID | 16484677
(Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
|
Chemical References |
|
Topics |
- Aged
- Blood Gas Analysis
- Cohort Studies
- Female
- Hospitalization
(statistics & numerical data)
- Humans
- Incidence
- Inflammation Mediators
(analysis)
- Male
- Middle Aged
- Pneumonia, Bacterial
(diagnosis, epidemiology)
- Pneumonia, Viral
(diagnosis, epidemiology)
- Probability
- Prognosis
- Pulmonary Disease, Chronic Obstructive
(diagnosis, epidemiology)
- Recurrence
- Respiratory Function Tests
- Respiratory Tract Infections
(diagnosis, epidemiology)
- Risk Assessment
- Severity of Illness Index
- Sputum
(cytology, microbiology)
|