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COPD Exacerbation-Related Pathogens and Previous COPD Treatment
- Title
- COPD Exacerbation-Related Pathogens and Previous COPD Treatment
- Authors
- Sim, Yun Su; Lee, Jin Hwa; Lee, Eung Gu; Choi, Joon Young; Lee, Chang-Hoon; An, Tai Joon; Park, Yeonhee; Yoon, Young Soon; Park, Joo Hun; Yoo, Kwang Ha
- Ewha Authors
- 이진화
- SCOPUS Author ID
- 이진화
- Issue Date
- 2023
- Journal Title
- JOURNAL OF CLINICAL MEDICINE
- ISSN
- 2077-0383
- Citation
- JOURNAL OF CLINICAL MEDICINE vol. 12, no. 1
- Keywords
- respiratory pathogen; chronic obstructive pulmonary disease; inhaler
- Publisher
- MDPI
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- We evaluated whether the pathogens identified during acute exacerbation of chronic obstructive pulmonary disease (AE-COPD) are associated with the COPD medications used in the 6 months before AE-COPD. We collected the medical records of patients diagnosed with AE-COPD at 28 hospitals between January 2008 and December 2019 and retrospectively analyzed them. Microorganisms identified at the time of AE-COPD were analyzed according to the use of inhaled corticosteroid (ICS) and systemic steroid after adjusting for COPD severity. We evaluated 1177 patients with AE-COPD and available medication history. The mean age of the patients was 73.9 +/- 9.2 years, and 83% were males. The most frequently identified bacteria during AE-COPD were Pseudomonas aeruginosa (10%), followed by Mycoplasma pneumoniae (9.4%), and Streptococcus pneumoniae (5.1%), whereas the most commonly identified viruses were rhinovirus (11%) and influenza A (11%). During AE-COPD, bacteria were more frequently identified in the ICS than non-ICS group (p = 0.009), and in the systemic steroid than non-systemic steroid group (p < 0.001). In patients who used systemic steroids before AE-COPD, the risk of detecting Pseudomonas aeruginosa was significantly higher during AE-COPD (OR 1.619, CI 1.007-2.603, p = 0.047), but ICS use did not increase the risk of Pseudomonas detection. The risk of respiratory syncytial virus (RSV) detection was low when ICS was used (OR 0.492, CI 0.244-0.988, p = 0.045). COPD patients who used ICS had a lower rate of RSV infection and similar rate of P. aeruginosa infection during AE-COPD compared to patients who did not use ICS. However, COPD patients who used systemic steroids within 6 months before AE-COPD had an increased risk of P. aeruginosa infection. Therefore, anti-pseudomonal antibiotics should be considered in patients with AE-COPD who have used systemic steroids.
- DOI
- 10.3390/jcm12010111
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
- Files in This Item:
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jcm-12-00111.pdf(2.3 MB)
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