PURPOSE: The most common cause of acute exacerbation of
chronic obstructive pulmonary disease (AECOPD) is respiratory
infection . Most studies of bacterial or viral cause in AECOPD have been conducted in Western countries. We investigated bacterial and viral identification rates in AECOPD in
Korea . MATERIALS AND
METHODS: We reviewed and analyzed
medical records of 736 cases of AECOPD at the
Korea University Guro
Hospital . We analyzed bacterial and viral identification rates and classified
infections according to epidemiological factors, such as Global Initiative for
Chronic Obstructive Lung Disease stage,
mortality , and
seasonal variation .
RESULTS: The numbers of AECOPD events involving only bacterial identification, only viral identification, bacterial-viral co-identification, and no identification were 200 (27.2%), 159 (21.6%), 107 (14.5%), and 270 (36.7%), respectively. The most common infectious
bacteria identified were
Pseudomonas aeruginosa (13.0%),
Streptococcus pneumoniae (11.4%), and
Haemophilus influenzae (5.3%); the most common
viruses identified were
influenza virus (12.4%),
rhinovirus (9.4%),
parainfluenza virus (5.2%), and
metapneumovirus (4.9%). The bacterial identification rate tended to be higher at more advanced stages of
chronic obstructive pulmonary disease (p=0.020 overall, p=0.011 for P. aeruginosa, p=0.048 for S. pneumoniae).
Staphylococcus aureus and
Klebsiella pneumoniae were identified more in
mortality group (p=0.003 for S. aureus, p=0.009 for K. pneumoniae). All
viruses were seasonal (i.e., greater
prevalence in a particular
season ; p < 0.050).
Influenza virus and
rhinovirus were mainly identified in the winter,
parainfluenza virus in the summer, and
metapneumovirus in the spring.
CONCLUSION: This information on the
epidemiology of
respiratory infections in AECOPD
will improve the management of AECOPD using
antibiotics and other
treatments in
Korea .