부산대학교 도서관

Background Respiratory infection is the most common reason for acute exacerbation of chronic obstructive pulmonary disease (AE-COPD). We aimed to investigate the etiology of the respiratory infection and the pathogen distribution in the acute exacerbation state of COPD according to GOLD classification. Methods From a multicenter cross-sectional study, we identified 467 AE-COPD patients and the pathogen profiles of the respiratory infection were collected from them. The pathogen was confirmed by conventional sputum, paired serology tests for atypical bacteria, and viral diagnostic techniques and classified by GOLD grade. Results All 467 COPD patients were classified into GOLD grade: group A (n=63, 13.5%), group B (n=140, 30.0%), group C (n=40, 8.6%), and group D (n=224, 48.0%). In most patients, no clear causative pathogen was identified for acute exacerbation, and 133 cases with confirmed pathogen were caused by a single pathogen of virus or bacteria. The distribution of the causative pathogen was identified to be different. In the cases of viruses, rhinovirus and coronavirus were found in group B, and rhinovirus and influenza A in group D patients. For bacteria, P. aeruginosa and K. pneumoniae were identified as major pathogen in group B, and P. aeruginosa, K. pneumoniae, S. pneumoniae, E. coli and H. influenzae in group D patients. Conclusions This study suggests that the causative pathogen was shown the various distribution when classified according to the GOLD ABCD classification in COPD patients with acute exacerbation.