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[Infectious agents associated with exacerbations of chronic obstructive bronchopneumopathies and asthma attacks]
Abstract:
Infections of the respiratory airways are frequently responsible for exacerbations of chronic obstructive pulmonary disease (COPD) and attacks of asthma. However, the causal infectious agents in practice are rarely precisely identified. We have undertaken a prospective study with the aim of researching into the bacteria and viruses associated with these exacerbations. Forty-seven patients who were in hospital between 1987 and 1989 for attacks of asthma (13 episodes) or exacerbations of COPD (35 episodes) were included in this study. The microbiological analysis consisted of: 1) the bacteriology of expectorated material or the products aspirated by fibroscopy with direct examination, quantitative cytology and culture; 2) samples taken from the nasal airways to identify and isolate pneumotropic viruses and mycoplasma; 3) serial serology looking for antibodies against pneumotropic bacteria and viruses. One of more infectious agents were shown in 47% of the episode studies of which 57% were exacerbations of COPD and treated 23% attacks of asthma. In the cases COPD bacteria were identified in 13 cases including Haemophilus influenzae [3], Streptococcus pneumoniae [3], Pseudomonas aeruginosa [3]. Amongst the 14 viruses recovered, the influenza virus [8] and the respiratory syncytial virus (VRS) [4] predominated. In 14 cases of acute asthma only 4 infectious agents were shown; Mycoplasma pneumoniae, influenza A, VRS and parainfluenza virus. The influenza virus was the agent most frequently discovered (26%) during the course of exacerbation of COPD and of asthma.
Insights
Respiratory infections frequently trigger chronic obstructive pulmonary disease (COPD) exacerbations and asthma attacks. This study identified bacteria and viruses, finding influenza virus most common in COPD and asthma exacerbations.
Area of Science:
- Respiratory Medicine
- Infectious Diseases
- Microbiology
Background:
- Respiratory infections are common triggers for exacerbations in patients with chronic obstructive pulmonary disease (COPD) and asthma.
- Precise identification of causative infectious agents during these exacerbations is often challenging in clinical practice.
Purpose of the Study:
- To prospectively investigate and identify specific bacteria and viruses associated with exacerbations of COPD and attacks of asthma.
- To determine the prevalence of different infectious agents in these respiratory conditions.
Main Methods:
- Prospective study involving 47 patients (35 COPD exacerbations, 13 asthma attacks) hospitalized between 1987-1989.
- Microbiological analysis included: bacteriology of respiratory samples (direct examination, cytology, culture), nasal airway sampling for viruses and mycoplasma, and serial serology for antibodies.
- Investigated expectorated material, fibroscopy aspirates, and nasal samples for infectious agents.
Main Results:
- Infectious agents were identified in 47% of studied episodes (57% of COPD exacerbations, 23% of asthma attacks).
- Commonly identified bacteria in COPD exacerbations included Haemophilus influenzae, Streptococcus pneumoniae, and Pseudomonas aeruginosa.
- Predominant viruses were influenza virus (26% overall) and respiratory syncytial virus (RSV). Mycoplasma pneumoniae was also identified in asthma cases.
Conclusions:
- A significant proportion of COPD exacerbations and asthma attacks are associated with identifiable infectious agents.
- Influenza virus is a frequent cause of both COPD exacerbations and asthma attacks.
- Comprehensive microbiological investigation is crucial for understanding and managing these respiratory events.