1. The roles of bacteria and viruses in COPD-Bronchiectasis association: A prospective cohort study.
- Author
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He ZF, Lin SZ, Pan CX, Chen ZM, Cen LJ, Zhang XX, Huang Y, Chen CL, Zha SS, Li HM, Lin ZH, Shi MX, Zhong NS, and Guan WJ
- Subjects
- Humans, Prospective Studies, Male, Female, Aged, Middle Aged, Bacteria isolation & purification, Viruses isolation & purification, Cohort Studies, Pulmonary Disease, Chronic Obstructive microbiology, Pulmonary Disease, Chronic Obstructive complications, Pulmonary Disease, Chronic Obstructive virology, Bronchiectasis microbiology, Bronchiectasis complications, Sputum microbiology, Sputum virology, Disease Progression
- Abstract
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., Competing Interests: Declaration of competing interest The authors declared no conflict of interest with any financial organization regarding the material discussed in the manuscript., (Copyright © 2024 Elsevier Ltd. All rights reserved.)
- Published
- 2024
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