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Importance of viral and bacterial infections in chronic obstructive pulmonary disease exacerbations
Open accessAbstract
Background Few studies have evaluated the contribution of both viruses and bacteria in acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Objectives This study estimated the burden of both types of pathogens among adults seeking care for an AECOPD during two consecutive winter seasons.Study design Patients 50 years or older who consulted within 10 days of AECOPD onset were eligible. Clinical data were collected on a standardized questionnaire, and nasopharyngeal aspirates (NPA), paired sera, and non-induced sputum were collected. Polymerase chain reaction (PRC) assays were used to identify viral, atypical and bacterial pathogens in NPA specimen.Results Overall, 108 patients with AECOPD were included, 88% of patients were admitted and 2 patients (2%) received intensive care. A third of patients (31%) had evidence of a viral infection, 9% with influenza A, 7% RSV and 7% with PIV-3. One patient was positive for Mycoplasma pneumoniae. Bacterial pathogens were identified in 49% of patients with available sputum, most frequently Staphylococcus aureus, Pseudomonas aeruginosa, and Haemophilus influenzae. Among virus-infected patients, 14 (58%) also had bacteria in their sputum, but co-infected patients did not present with different symptoms than patients with single infections.Conclusions These results suggest that influenza and RSV are frequent contributors of AECOPD, and that coinfection with bacteria does not appear to be more severe among virus-infected patients. Clinicians should be aware that AECOPD may be frequently triggered by viruses, and may consider antivirals and proper infection control measures in appropriate epidemiological setting.
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“Human metapneumovirus and the V protein of parainfluenza virus 5, for instance, block IFN signaling by inhibiting or degrading STAT-1 (47, 329).”
From The airway epithelium: soldier in the fight against respiratory viruses (2011) · cites this paper as [47]
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Infective Exacerbations of Chronic Lung Disease
Mallia, P., Coultas, J. A., & Cafferkey, J. (2021) · Elsevier eBooks · doi:10.1016/b978-0-08-102723-3.00138-4
Sert, A. A. E., Avcı, G. A., & Arslan, S. (2023) · Indian Journal of Medical Sciences · doi:10.25259/ijms_207_2023
Enhanced detection of respiratory pathogens using PCR in COPD and asthma exacerbations
Gegin, S., Pazarlı, A. C., Özdemir, B., Özdemir, L., & Aksu, E. A. (2025) · Folia Medica · doi:10.3897/folmed.67.e152245
Determinants of exacerbation frequency in COPD
Quint, J. K. (2010) · UCL Discovery (University College London)
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Metadata
- Authors
- De Serres, G., Lampron, N., La Forge, J., Rouleau, I., Bourbeau, J., Weiss, K., Barret, B., & Boivin, G.
- Affiliations
- Centre hospitalier universitaire de Québec (CA)
- Montreal Chest Institute (CA)
- Hôpital Maisonneuve-Rosemont (CA)
- Sanofi (France) (FR)
- Centre hospitalier de l'Université Laval (CA)
- Venue
- Journal of Clinical Virology
- Publisher
- Elsevier BV
- Published
- 2009-10
- Volume
- 46
- Issue
- 2
- Pages
- 129-133
- ISSN
- 1386-6532 (ISSN-L)
- PMC
- PMC7108387
- OpenAlex
- W2051682127
- Cited by
- 108
- References
- 32
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 4 · 2023: 5 · 2022: 3 · 2021: 4 · 2020: 9 · 2019: 2 · 2018: 3 · 2017: 6 · 2016: 6 · 2015: 16 · 2014: 5 · 2013: 10 · 2012: 8
- FWCI
- 8.14
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Clinical Virology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Sanofi Pasteur
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Epidemiology › Respiratory viral infections research
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Asthma and respiratory diseases
- Keywords
- COPD exacerbations, viral infection, bacterial infection, influenza A virus, respiratory syncytial virus, parainfluenza virus type 3, Mycoplasma pneumoniae, Staphylococcus aureus, Pseudomonas aeruginosa, Haemophilus influenzae, co-infection, winter
- MeSH terms
- Aged, Bacterial Infections, Female, Humans, Influenza, Human, Male, Middle Aged, Influenza A virus, Respiratory Syncytial Viruses, Respiratory Tract Infections, Risk Factors, Sputum, Virus Diseases, Respiratory Syncytial Virus Infections, Pulmonary Disease, Chronic Obstructive
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