KMID : 1044520220850010037
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Tuberculosis and Respiratory Diseases 2022 Volume.85 No. 1 p.37 ~ p.46
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A Multicenter Study to Identify the Respiratory Pathogens Associated with Exacerbation of Chronic Obstructive Pulmonary Disease in Korea
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Lee Hyun-Woo
Sim Yun-Su Jung Ji-Ye Seo Hye-Won Park Jeong-Woong Min Kyung-Hoon Lee Jae-Ha Kim Byung-Keun Lee Myung-Goo Oh Yeon-Mok Ra Seung-Won Kim Tae-Hyung Hwang Yong-Il Rhee Chin-Kook Joo Hyon-Soo Lee Eung-Gu Lee Jin-Hwa Park Hye-Yun Kim Woo-Jin Um Soo-Jung Choi Joon-Young Lee Chang-Hoon An Tai-Joon Park Yeon-Hee Yoon Young-Soon Park Joo-Hun Yoo Kwang-Ha Kim Deog-Kyeom
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Abstract
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Background: Although 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.
Methods: A 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.
Results: We 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).
Conclusion: Distinct 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.
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KEYWORD
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Symptom Flare Up, Pulmonary Disease, Chronic Obstructive, Microbiology, Bacteriology, Virology
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