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Infectious etiologies in acute exacerbation of COPD
D Lieberman1, D Lieberman, M Ben-Yaakov
1Pulmonary Unit and Division of Internal Medicine, Soroka Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel. Lieberma@bgumail.bgu.ac.il
Infections causing acute exacerbations of chronic obstructive pulmonary disease (COPD) are often viral or atypical bacteria, not classic bacteria. Antibiotic strategies for COPD exacerbations should consider atypical pathogens.
Area of Science:
- Pulmonology
- Infectious Diseases
- Microbiology
Background:
- Acute exacerbations (AE) are common and serious events in chronic obstructive pulmonary disease (COPD).
- Identifying infectious etiologies is crucial for effective treatment and management of AECOPD.
Purpose of the Study:
- To determine the frequency distribution of infectious causes in hospitalizations for acute exacerbations of COPD (AECOPD).
Main Methods:
- Prospective serological study of 240 hospitalizations for AECOPD.
- Paired sera tested for 13 pathogens using immunofluorescence or EIA, with significant antibody titer changes as diagnostic criteria.
Main Results:
- Infectious etiology identified in 72.9% of hospitalizations.
- Viral etiologies found in 48.8%, atypical bacteria in 30.0% (Legionella, Mycoplasma pneumoniae), and classic bacteria in 24.2% (Streptococcus pneumoniae).
- Multiple etiologies identified in 30.0% of cases; no association with exacerbation severity or type.
Conclusions:
- Viral and atypical bacterial infections are the most frequent causes of AECOPD hospitalizations.
- Classic bacterial infections are less common.
- Antibiotic regimens for AECOPD should include coverage for atypical bacteria.
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