학술논문
Clinical Significance of Various Pathogens in Acute Exacerbations of COPD: Multi-center Study in Korea
Document Type
Article
Author
Hyun Woo Ji; Ji Ye Jung; Soojoung Yu; Hyun Woo Lee; Yun Su Sim; Hyewon Seo; Jeong-Woong Park; Kyung Hoon Min; Jae Ha Lee; Byung-Keun Kim; Myung Goo Lee; Yeon Mok Oh; Seung Won Ra; Tae- Hyung Kim; Yong Il Hwang; Chin Kook Rhee; Hyonsoo Joo; Eung Gu Lee; Jin Hwa Lee; Hye Yun Park; Woo Jin Kim; Soo-Jung Um; Joon Young Choi; Chang-Hoon Lee; An Tai Joon; Yeonhee Park; Young-Soon Yoon; Joo Hun Park; Kwang Ha Yoo; Deog Jyeom
Source
대한결핵및호흡기학회 추계학술발표초록집. Nov 30, 2021 129:337
Subject
Language
Korean
English
English
Abstract
Background One of the major causes of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is respiratory infection. In this study, we investigated types of bacteria and virus identified in AECOPD patients in Korea, and compared clinical difference according to different types of pathogen Methods We reviewed 1186 cases of AECOPD patients recruited at 28 hospitals in Korea from January 2015 to December 2019. Pathogen was identified by microbiological tests. We analyzed bacterial and viral identification rate, along with basic characteristics and clinical presentation of patients associated with the different types of pathogens, and risk factors for potentially drug-resistant (PDR) pathogen. Results The number of patients infected with bacteria, virus, and both bacteria and virus were 262 (22.1%), 265 (22.5%), and 129 (10.9%), respectively. The most common bacteria identified were Pseudomonas aeruginosa (9.8%), Mycoplasma pneumoniae (6.2%), and Streptococcus pneumoniae (5.0%). The most common virus identified Influenza A (10.4%), Rhinovirus (8.7%), and RSV (3.5%) Compared to patients without identified pathogens, patient with identified pathogens had a higher rate of systemic steroid use within six months (22.7% vs 16.9%; P=0.015), presented more cough and sputum (76.4% vs 68.9%; P=0.004, 78.9% vs 68.7%; P=0.015), and required longer period of systemic steroid during AECOPD (11.2days vs 4.4days; P=0.012). Past history of pulmonary tuberculosis (OR 1.66; P=0.046) and bronchiectasis (OR 1.99; P=0.032), and the history of triple inhaler use within six months (OR 2.04; P=0.005) have been confirmed as risk factors for the identification of PDR pathogen. In addition, hospital stay was longer (15.9days vs 12.4days; P=0.018) and ICU admission rate was high (15.9% vs 9.5%; P=0.030) when PDR pathogen was identified Conclusions The various types of pathogens caused AECOPD. In addition, risk factors for the identification of PDR pathogen were past history of pulmonary tuberculosis and bronchiectasis, and history of triple inhaler use.