help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Published ahead of print on May 3, 2007, doi:10.1164/rccm.200703-417OC

Am. J. Respir. Crit. Care Med., Volume 176, Number 4, August 2007, 356-361

A more recent version of this article appeared on August 15, 2007
This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
200703-417OCv1
176/4/356    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Sethi, S.
Right arrow Articles by Murphy, T. F
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Sethi, S.
Right arrow Articles by Murphy, T. F

Submitted on March 13, 2007
Accepted on May 3, 2007

Airway Bacterial Concentrations and Exacerbations of Chronic Obstructive Pulmonary Disease

Sanjay Sethi1*, Rohin Sethi2, Karen Eschberger2, Phyllis Lobbins3, Xueya Cai4, Brydon JB Grant1, and Timothy F Murphy5

1 Division of Pulmonary and Critical Care and Sleep Medicine, University at Buffalo, State University of New York, Buffalo, NY, USA; Veterans Affairs Western New York Healthcare System, Buffalo, NY, USA, 2 Veterans Affairs Western New York Healthcare System, Buffalo, NY, USA, 3 Division of Infectious Diseases, Department of Medicine and Department of Microbiology, University at Buffalo, State University of New York, Buffalo, NY, USA, 4 Department of Biostatistics, University at Buffalo, State University of New York, Buffalo, NY, USA, 5 Division of Infectious Diseases, Department of Medicine and Department of Microbiology, 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: ssethi{at}buffalo.edu.

Rationale: Increased bacterial concentration (load) in the lower airways and new bacterial strain acquisition have been posited as mechanisms for COPD exacerbations. Bacterial concentrations are higher during exacerbation than during stable disease, however, these studies are cross-sectional and devoid of strain typing. Objectives: To determine if the increased bacterial concentrations function as a separate mechanism for exacerbation induction independent of new strain acquisition. Methods: In a prospective longitudinal cohort of COPD patients, the relationship between exacerbation occurrence, sputum bacterial concentrations and new strain acquisition was examined. Measurements: Clinical information, quantitative sputum cultures and molecular typing of potential bacterial pathogen isolates. Main Results: Over 81 months, 104 subjects completed 3009 clinic visits, 560 (19.6%) during exacerbations and 2449 (80.4%) stable visits. Among pre-existing strains, sputum concentrations of Nontypeable Haemophilus influenzae and Haemophilus haemolyticus were not different in exacerbation vs.stable disease. Moraxella catarrhalis (Stable 108.38±0.13 vs. Exacerbation 107.78±0.26, p=0.02) and Streptococcus pneumoniae (Stable 108.42±0.21 vs. Exacerbation 107.76±0.52, p=0.07)concentrations were lower during exacerbations vs. stable periods. Concentrations of new strains of H. influenzae (Stable 107.28±0.15 vs. Exacerbation 107.76±0.17, p=0.04) and M. catarrhalis (Stable 107.85±0.15 vs. Exacerbation 108.37±0.14, p=0.02), were increased during exacerbations, however, the differences were small. Conclusions: Change in bacterial load is unlikely to be an important mechanism for exacerbations. Better understanding of the host-pathogen interaction rather than enumerating bacteria in respiratory samples is required to provide new insights into bacterial infection in COPD.
Key words: COPD, exacerbation, bacteria




This article has been cited by other articles:


Home page
 Eur Respir JHome page
M. Miravitlles, A. Marin, E. Monso, S. Vila, C. de la Roza, R. Hervas, C. Esquinas, M. Garcia, L. Millares, J. Morera, et al.
Efficacy of moxifloxacin in the treatment of bronchial colonisation in COPD
Eur. Respir. J., November 1, 2009; 34(5): 1066 - 1071.
[Abstract] [Full Text] [PDF]

Home page
 Microbiol. Mol. Biol. Rev.Home page
S. P. W. de Vries, H. J. Bootsma, J. P. Hays, and P. W. M. Hermans
Molecular Aspects of Moraxella catarrhalis Pathogenesis
Microbiol. Mol. Biol. Rev., September 1, 2009; 73(3): 389 - 406.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
G. G. Brusselle, T. Demoor, K. R. Bracke, C-A. Brandsma, and W. Timens
Lymphoid follicles in (very) severe COPD: beneficial or harmful?
Eur. Respir. J., July 1, 2009; 34(1): 219 - 230.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
W. Janssens, A. Lehouck, C. Carremans, R. Bouillon, C. Mathieu, and M. Decramer
Vitamin D Beyond Bones in Chronic Obstructive Pulmonary Disease: Time to Act
Am. J. Respir. Crit. Care Med., April 15, 2009; 179(8): 630 - 636.
[Abstract] [Full Text] [PDF]

Home page
 MicrobiologyHome page
P. E. Bratcher, I. H. Park, S. K. Hollingshead, and M. H. Nahm
Production of a unique pneumococcal capsule serotype belonging to serogroup 6
Microbiology, February 1, 2009; 155(2): 576 - 583.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
S. Sethi and T. F. Murphy
Infection in the Pathogenesis and Course of Chronic Obstructive Pulmonary Disease
N. Engl. J. Med., November 27, 2008; 359(22): 2355 - 2365.
[Full Text] [PDF]

Home page
 Infect. Immun.Home page
B. Pang, W. Hong, S. L. West-Barnette, N. D. Kock, and W. E. Swords
Diminished ICAM-1 Expression and Impaired Pulmonary Clearance of Nontypeable Haemophilus influenzae in a Mouse Model of Chronic Obstructive Pulmonary Disease/Emphysema
Infect. Immun., November 1, 2008; 76(11): 4959 - 4967.
[Abstract] [Full Text] [PDF]

Home page
 Infect. Immun.Home page
B. Pang, D. Winn, R. Johnson, W. Hong, S. West-Barnette, N. Kock, and W. E. Swords
Lipooligosaccharides Containing Phosphorylcholine Delay Pulmonary Clearance of Nontypeable Haemophilus influenzae
Infect. Immun., May 1, 2008; 76(5): 2037 - 2043.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
S. Sethi and T. F. Murphy
Bacterial Load and Exacerbations of COPD
Am. J. Respir. Crit. Care Med., May 1, 2008; 177(9): 1049 - 1049.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
H. Abusriwil and R. A. Stockley
Bacterial Load and Exacerbations of COPD
Am. J. Respir. Crit. Care Med., May 1, 2008; 177(9): 1048 - 1049.
[Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
H. Abusriwil and R. A. Stockley
The Interaction of Host and Pathogen Factors in Chronic Obstructive Pulmonary Disease Exacerbations and Their Role in Tissue Damage
Proceedings of the ATS, December 1, 2007; 4(8): 611 - 617.
[Abstract] [Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
A. Sykes, P. Mallia, and S. L. Johnston
Diagnosis of Pathogens in Exacerbations of Chronic Obstructive Pulmonary Disease
Proceedings of the ATS, December 1, 2007; 4(8): 642 - 646.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
T. M. A. Wilkinson
Host Pathogen Interactions during COPD Exacerbations: Moving on from Microbiology by Numbers?
Am. J. Respir. Crit. Care Med., August 15, 2007; 176(4): 323 - 325.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 2007 American Thoracic Society 		  CCM abstracts