Clinical Significance of Various Pathogens Identified in Patients Experiencing Acute Exacerbations of COPD: A Multi-center Study in South Korea

초록

Background: Respiratory infections play a major role in acute exacerbation of chronicobstructive pulmonary disease (AECOPD). This study assessed the prevalence of bacterialand viral pathogens and their clinical impact on patients with AECOPD. Methods: This retrospective study included 1,186 patients diagnosed with AECOPDat 28 hospitals in South Korea between 2015 and 2018. We evaluated the identificationrates of pathogens, basic patient characteristics, clinical features, and the factorsassociated with infections by potentially drug-resistant (PDR) pathogens using variousmicrobiological tests. Results: Bacteria, viruses, and both were detected in 262 (22.1%), 265 (22.5%), and 129(10.9%) of patients, respectively. The most common pathogens included Pseudomonasaeruginosa (17.8%), Mycoplasma pneumoniae (11.2%), Streptococcus pneumoniae(9.0%), influenza A virus (19.0%), rhinovirus (15.8%), and respiratory syncytial virus(6.4%). Notably, a history of pulmonary tuberculosis (odds ratio [OR], 1.66; p=0.046),bronchiectasis (OR, 1.99; p=0.032), and the use of a triple inhaler regimen within thepast 6 months (OR, 2.04; p=0.005) were identified as significant factors associated withinfection by PDR pathogens. Moreover, patients infected with PDR pathogens exhibitedextended hospital stays (15.9 days vs. 12.4 days, p=0.018) and higher intensive care unitadmission rates (15.9% vs. 9.5%, p=0.030). Conclusion: This study demonstrates that a variety of pathogens are involved in episodesof AECOPD. Nevertheless, additional research is required to confirm their role inthe onset and progression of AECOPD.

키워드