Zhen-feng He , Sheng-zhu Lin , Cui-xia Pan , Zhao-ming Chen , Lai-jian Cen , Xiao-xian Zhang , Yan Huang , Chun-lan Chen , Shan-shan Zha , Hui-min Li , Zhen-hong Lin , Ming-xin Shi , Nan-shan Zhong , Wei-jie Guan
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We aimed to determine the bacterial and viral spectrum at stable-state and exacerbation onset of CBA, and their association with exacerbations and clinical outcomes of CBA as compared with bronchiectasis.</p></div><div><h3>Methods</h3><p>We prospectively collected spontaneous sputum from adults with CBA, bronchiectasis with (BO) and without airflow obstruction (BNO) for bacterial culture and viral detection at stable-state and exacerbations.</p></div><div><h3>Results</h3><p>We enrolled 76 patients with CBA, 58 with BO, and 138 with BNO (711 stable and 207 exacerbation visits). Bacterial detection rate increased from BNO, CBA to BO at steady-state (<em>P</em> = 0.02), but not at AE onset (<em>P</em> = 0.91). No significant differences in viral detection rate were found among BNO, CBA and BO. Compared with steady-state, viral isolations occurred more frequently at exacerbation in BNO (15.8 % vs 32.1 %, <em>P</em> = 0.001) and CBA (19.5 % vs 30.6 %, <em>P</em> = 0.036) only. In CBA, isolation of viruses, human metapneumovirus and bacteria plus viruses was associated with exacerbation. Repeated detection of <em>Pseudomonas aeruginosa</em> (PA) correlated with higher modified Reiff score (<em>P</em> = 0.032) in CBA but not in BO (<em>P</em> = 0.178). Repeated detection of PA yielded a shorter time to the first exacerbation in CBA [median: 4.3 vs 11.1 months, <em>P</em> = 0.006] but not in BO (median: 8.4 vs 7.6 months, <em>P</em> = 0.47).</p></div><div><h3>Conclusions</h3><p>Isolation of any viruses, human metapneumovirus and bacterialplus viruses was associated with CBA exacerbations. Repeated detection of PA confers greater impact of future exacerbations on CBA than on BO.</p></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":null,"pages":null},"PeriodicalIF":3.5000,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The roles of bacteria and viruses in COPD-Bronchiectasis association: A prospective cohort study\",\"authors\":\"Zhen-feng He , Sheng-zhu Lin , Cui-xia Pan , Zhao-ming Chen , Lai-jian Cen , Xiao-xian Zhang , Yan Huang , Chun-lan Chen , Shan-shan Zha , Hui-min Li , Zhen-hong Lin , Ming-xin Shi , Nan-shan Zhong , Wei-jie Guan\",\"doi\":\"10.1016/j.rmed.2024.107692\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Exacerbations are implicated in bronchiectasis and COPD, which frequently co-exist [COPD-Bronchiectasis association (CBA)]. We aimed to determine the bacterial and viral spectrum at stable-state and exacerbation onset of CBA, and their association with exacerbations and clinical outcomes of CBA as compared with bronchiectasis.</p></div><div><h3>Methods</h3><p>We prospectively collected spontaneous sputum from adults with CBA, bronchiectasis with (BO) and without airflow obstruction (BNO) for bacterial culture and viral detection at stable-state and exacerbations.</p></div><div><h3>Results</h3><p>We enrolled 76 patients with CBA, 58 with BO, and 138 with BNO (711 stable and 207 exacerbation visits). Bacterial detection rate increased from BNO, CBA to BO at steady-state (<em>P</em> = 0.02), but not at AE onset (<em>P</em> = 0.91). No significant differences in viral detection rate were found among BNO, CBA and BO. Compared with steady-state, viral isolations occurred more frequently at exacerbation in BNO (15.8 % vs 32.1 %, <em>P</em> = 0.001) and CBA (19.5 % vs 30.6 %, <em>P</em> = 0.036) only. In CBA, isolation of viruses, human metapneumovirus and bacteria plus viruses was associated with exacerbation. Repeated detection of <em>Pseudomonas aeruginosa</em> (PA) correlated with higher modified Reiff score (<em>P</em> = 0.032) in CBA but not in BO (<em>P</em> = 0.178). Repeated detection of PA yielded a shorter time to the first exacerbation in CBA [median: 4.3 vs 11.1 months, <em>P</em> = 0.006] but not in BO (median: 8.4 vs 7.6 months, <em>P</em> = 0.47).</p></div><div><h3>Conclusions</h3><p>Isolation of any viruses, human metapneumovirus and bacterialplus viruses was associated with CBA exacerbations. 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引用次数: 0
摘要
背景:支气管扩张症和慢性阻塞性肺病经常并存,而这两种疾病的加重与支气管扩张症有关[慢性阻塞性肺病-支气管扩张症并存(CBA)]。我们的目的是确定 CBA 稳定状态和恶化开始时的细菌和病毒谱,以及与支气管扩张症相比,病原体检测与 CBA 恶化之间的关联:我们前瞻性地收集了CBA、伴气流阻塞(BO)和不伴气流阻塞(BNO)的支气管扩张成人患者的自发痰液,用于细菌培养和病毒检测:我们共收治了 76 名 CBA 患者、58 名 BO 患者和 138 名 BNO 患者(其中稳定期 711 人次,加重期 207 人次)。从 BNO、CBA 到 BO,细菌检出率在稳定期有所上升(P=0.02),但在急性发作期没有上升(P=0.91)。BNO、CBA和BO的病毒检出率无明显差异。与稳态相比,仅在 BNO(15.8% vs 32.1%,P=0.001)和 CBA(19.5% vs 30.6%,P=0.036)中,病情加重时病毒分离率更高。在 CBA 中,病毒、人类偏肺病毒和细菌加病毒的分离与病情加重有关。在 CBA 中,重复检测到铜绿假单胞菌与较高的改良雷夫评分相关(P=0.032),但在 BO 中则不相关(P=0.178)。重复检测铜绿假单胞菌可缩短CBA患者首次病情加重的时间[中位数:4.3个月 vs 11.1个月,P=0.006],但不会缩短BO患者首次病情加重的时间(中位数:8.4个月 vs 7.6个月,P=0.47):结论:CBA 患者的疾病严重程度高于 BNO 患者。结论:CBA 患者的疾病严重程度高于 BNO 患者。虽然病毒分离与 CBA 病情加重有关,但重复检测铜绿假单胞菌对 CBA 患者未来病情加重的影响大于对 BNO 患者的影响。
The roles of bacteria and viruses in COPD-Bronchiectasis association: A prospective cohort study
Background
Exacerbations are implicated in bronchiectasis and COPD, which frequently co-exist [COPD-Bronchiectasis association (CBA)]. We aimed to determine the bacterial and viral spectrum at stable-state and exacerbation onset of CBA, and their association with exacerbations and clinical outcomes of CBA as compared with bronchiectasis.
Methods
We prospectively collected spontaneous sputum from adults with CBA, bronchiectasis with (BO) and without airflow obstruction (BNO) for bacterial culture and viral detection at stable-state and exacerbations.
Results
We enrolled 76 patients with CBA, 58 with BO, and 138 with BNO (711 stable and 207 exacerbation visits). Bacterial detection rate increased from BNO, CBA to BO at steady-state (P = 0.02), but not at AE onset (P = 0.91). No significant differences in viral detection rate were found among BNO, CBA and BO. Compared with steady-state, viral isolations occurred more frequently at exacerbation in BNO (15.8 % vs 32.1 %, P = 0.001) and CBA (19.5 % vs 30.6 %, P = 0.036) only. In CBA, isolation of viruses, human metapneumovirus and bacteria plus viruses was associated with exacerbation. Repeated detection of Pseudomonas aeruginosa (PA) correlated with higher modified Reiff score (P = 0.032) in CBA but not in BO (P = 0.178). Repeated detection of PA yielded a shorter time to the first exacerbation in CBA [median: 4.3 vs 11.1 months, P = 0.006] but not in BO (median: 8.4 vs 7.6 months, P = 0.47).
Conclusions
Isolation of any viruses, human metapneumovirus and bacterialplus viruses was associated with CBA exacerbations. Repeated detection of PA confers greater impact of future exacerbations on CBA than on BO.
期刊介绍:
Respiratory Medicine is an internationally-renowned journal devoted to the rapid publication of clinically-relevant respiratory medicine research. It combines cutting-edge original research with state-of-the-art reviews dealing with all aspects of respiratory diseases and therapeutic interventions. Topics include adult and paediatric medicine, epidemiology, immunology and cell biology, physiology, occupational disorders, and the role of allergens and pollutants.
Respiratory Medicine is increasingly the journal of choice for publication of phased trial work, commenting on effectiveness, dosage and methods of action.