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Published ahead of print on April 1, 2005, doi:10.1164/rccm.200412-1747OC

Am. J. Respir. Crit. Care Med., Volume 172, Number 2, July 2005, 195-199

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Submitted on December 24, 2004
Accepted on March 30, 2005

Moraxella catarrhalis in Chronic Obstructive Pulmonary Disease:Burden of Disease and Immune Response

Timothy F Murphy1*, Aimee L Brauer2, Brydon JB Grant3, and Sanjay Sethi4

1 Division of Infectious Diseases, Department of Medicine, University at Buffalo, State University of New York, Buffalo, NY, USA; Department of Microbiology, University at Buffalo, State University of New York, Buffalo, NY, USA; Veterans Affairs Western New York Healthcare System, Buffalo, NY, USA, 2 Division of Infectious Diseases, Department of Medicine, University at Buffalo, State University of New York, Buffalo, NY, USA, 3 Division of Pulmonary and Critical Care Medicine, Department of Medicine, University at Buffalo, State University of New York, Buffalo, NY, USA; Departments of Physiology and Biophysics, Social and Preventive Medicine, and Biostatistics, University at Buffalo, State University of New York, Buffalo, NY, USA; Veterans Affairs Western New York Healthcare System, Buffalo, NY, USA, 4 Division of Pulmonary and Critical Care Medicine, Department of Medicine, University at Buffalo, State University of New York, Buffalo, NY, USA; Veterans Affairs Western New York Healthcare System, Buffalo, NY, USA

* To whom correspondence should be addressed. E-mail: murphyt{at}buffalo.edu.

Rationale. Moraxella catarrhalis is frequently present in sputum of adults with chronic obstructive pulmonary disease (COPD). Remarkably little is known about the role of M. catarrhalis in this common disease. Objective. To elucidate the burden of disease, dynamics of carriage, and immune responses to M. catarrhalis in COPD. Methods. Prospective cohort study of 104 adults with COPD in an outpatient clinic at the Buffalo VA Medical Center. Measurements. Clinical information, sputum cultures, molecular typing of isolates, immunoassays to measure antibodies to M. catarrhalis. Main Results. Over 81 months, 104 patients made 3009 clinic visits, 560 during exacerbations. Molecular typing identified 120 episodes of acquisition and clearance of M. catarrhalis in 50 patients; 57 (47.5%) of the acquisitions were associated with clinical exacerbations. No instances of simultaneous acquisition of new strain of another pathogen were observed. The duration of carriage of M. catarrhalis was shorter with exacerbations than asymptomatic colonization (median 31.0 days vs. 40.4, p = 0.01). Reacquisition of the same strain was rare. The intensity of the serum IgG response was greater following exacerbations than asymptomatic colonization (p = 0.009). Asymptomatic colonization was associated with a greater frequency of sputum IgA response than exacerbation (p = 0.009). Conclusions. M. catarrhalis likely causes approximately 10% of exacerbations of COPD, accounting for approximately 2 to 4 million episodes annually. The organism is cleared efficiently following a short duration of carriage. Patients develop strain-specific protection following clearance of M. catarrhalis from the respiratory tract.
Key words: respiratory tract infection, mucosal immunity, chronic bronchitis




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