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The Proceedings of the American Thoracic Society 4:642-646 (2007)
© 2007 The American Thoracic Society
doi: 10.1513/pats.200707-101TH
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Diagnosis of Pathogens in Exacerbations of Chronic Obstructive Pulmonary Disease

Annemarie Sykes1, Patrick Mallia1 and Sebastian L. Johnston1

1 Department of Respiratory Medicine, National Heart and Lung Institute and Wright Fleming Institute of Infection and Immunity, Imperial College London, London, United Kingdom

Correspondence and requests for reprints should be addressed to Professor S. L. Johnston, MB. B.S., Ph.D., Department of Respiratory Medicine, National Heart and Lung Institute and Wright Fleming Institute Infection and Immunity, Imperial College London, Norfolk Place, London, W2 1PG, UK. E-mail: s.johnston{at}imperial.ac.uk

ABSTRACT

Chronic obstructive pulmonary disease (COPD) is increasing in prevalence. Acute exacerbations of COPD are the major cause worldwide of morbidity, mortality, and health care costs as well as decreased quality of life for the individual. The majority of exacerbations are infectious in etiology. Bacteria are detected in 50% of exacerbations and polymerase chain reaction techniques have established that, in half to two-thirds of exacerbations, viruses are causative pathogens. Combined bacterial and viral infection can be identified in 25% of exacerbations and these dual infections are often more severe. Despite occurring frequently, the mechanisms by which infection with these pathogens causes exacerbations are incompletely understood. This highlights the need for continued research, because a greater understanding of the mechanism of COPD exacerbations may lead to identification of potential targets for the development of therapeutic options for this increasingly common condition.

Key Words: chronic obstructive pulmonary disease • bacterial infection • viral infection






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