Clinical Significance of Various Pathogens Identified in Patients Experiencing Acute Exacerbations of COPD: A Multi-center Study in South Korea

Background Respiratory infections play a major role in acute exacerbation of chronic obstructive pulmonary disease (AECOPD). This study assessed the prevalence of bacterial and viral pathogens and their clinical impact on patients with AECOPD. Methods This retrospective study included 1,186 patients...

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Main Authors: Hyun Woo Ji, Soojoung Yu, Yun Su Sim, Hyewon Seo, Jeong-Woong Park, Kyung Hoon Min, Deog Kyeom Kim, Hyun Woo Lee, Chin Kook Rhee, Yong Bum Park, Kyeong-Cheol Shin, Kwang Ha Yoo, Ji Ye Jung
Format: Article
Language:English
Published: The Korean Academy of Tuberculosis and Respiratory Diseases 2025-04-01
Series:Tuberculosis and Respiratory Diseases
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Online Access:http://e-trd.org/upload/pdf/trd-2024-0089.pdf
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author Hyun Woo Ji
Soojoung Yu
Yun Su Sim
Hyewon Seo
Jeong-Woong Park
Kyung Hoon Min
Deog Kyeom Kim
Hyun Woo Lee
Chin Kook Rhee
Yong Bum Park
Kyeong-Cheol Shin
Kwang Ha Yoo
Ji Ye Jung
author_facet Hyun Woo Ji
Soojoung Yu
Yun Su Sim
Hyewon Seo
Jeong-Woong Park
Kyung Hoon Min
Deog Kyeom Kim
Hyun Woo Lee
Chin Kook Rhee
Yong Bum Park
Kyeong-Cheol Shin
Kwang Ha Yoo
Ji Ye Jung
author_sort Hyun Woo Ji
collection DOAJ
description Background Respiratory infections play a major role in acute exacerbation of chronic obstructive pulmonary disease (AECOPD). This study assessed the prevalence of bacterial and viral pathogens and their clinical impact on patients with AECOPD. Methods This retrospective study included 1,186 patients diagnosed with AECOPD at 28 hospitals in South Korea between 2015 and 2018. We evaluated the identification rates of pathogens, basic patient characteristics, clinical features, and the factors associated with infections by potentially drug-resistant (PDR) pathogens using various microbiological tests. Results Bacteria, viruses, and both were detected in 262 (22.1%), 265 (22.5%), and 129 (10.9%) of patients, respectively. The most common pathogens included Pseudomonas aeruginosa (17.8%), Mycoplasma pneumoniae (11.2%), Streptococcus pneumoniae (9.0%), influenza A virus (19.0%), rhinovirus (15.8%), and respiratory syncytial virus (6.4%). Notably, a history of pulmonary tuberculosis (odds ratio [OR], 1.66; p=0.046), bronchiectasis (OR, 1.99; p=0.032), and the use of a triple inhaler regimen within the past 6 months (OR, 2.04; p=0.005) were identified as significant factors associated with infection by PDR pathogens. Moreover, patients infected with PDR pathogens exhibited extended hospital stays (15.9 days vs. 12.4 days, p=0.018) and higher intensive care unit admission rates (15.9% vs. 9.5%, p=0.030). Conclusion This study demonstrates that a variety of pathogens are involved in episodes of AECOPD. Nevertheless, additional research is required to confirm their role in the onset and progression of AECOPD.
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spelling doaj-art-a544d1da2ec647d29e5ea949d670558e2025-08-20T01:54:15ZengThe Korean Academy of Tuberculosis and Respiratory DiseasesTuberculosis and Respiratory Diseases1738-35362005-61842025-04-0188229230210.4046/trd.2024.00894912Clinical Significance of Various Pathogens Identified in Patients Experiencing Acute Exacerbations of COPD: A Multi-center Study in South KoreaHyun Woo Ji0Soojoung Yu1Yun Su Sim2Hyewon Seo3Jeong-Woong Park4Kyung Hoon Min5Deog Kyeom Kim6Hyun Woo Lee7Chin Kook Rhee8Yong Bum Park9Kyeong-Cheol Shin10Kwang Ha Yoo11Ji Ye Jung12 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea International Healthcare Center, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea Division of Pulmonary, Allergy and Critical Care Medicine, Hallym University Kangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Republic of Korea Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Republic of Korea Division of Pulmonology and Allergy, Department of Internal Medicine, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Republic of Korea Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of KoreaBackground Respiratory infections play a major role in acute exacerbation of chronic obstructive pulmonary disease (AECOPD). This study assessed the prevalence of bacterial and viral pathogens and their clinical impact on patients with AECOPD. Methods This retrospective study included 1,186 patients diagnosed with AECOPD at 28 hospitals in South Korea between 2015 and 2018. We evaluated the identification rates of pathogens, basic patient characteristics, clinical features, and the factors associated with infections by potentially drug-resistant (PDR) pathogens using various microbiological tests. Results Bacteria, viruses, and both were detected in 262 (22.1%), 265 (22.5%), and 129 (10.9%) of patients, respectively. The most common pathogens included Pseudomonas aeruginosa (17.8%), Mycoplasma pneumoniae (11.2%), Streptococcus pneumoniae (9.0%), influenza A virus (19.0%), rhinovirus (15.8%), and respiratory syncytial virus (6.4%). Notably, a history of pulmonary tuberculosis (odds ratio [OR], 1.66; p=0.046), bronchiectasis (OR, 1.99; p=0.032), and the use of a triple inhaler regimen within the past 6 months (OR, 2.04; p=0.005) were identified as significant factors associated with infection by PDR pathogens. Moreover, patients infected with PDR pathogens exhibited extended hospital stays (15.9 days vs. 12.4 days, p=0.018) and higher intensive care unit admission rates (15.9% vs. 9.5%, p=0.030). Conclusion This study demonstrates that a variety of pathogens are involved in episodes of AECOPD. Nevertheless, additional research is required to confirm their role in the onset and progression of AECOPD.http://e-trd.org/upload/pdf/trd-2024-0089.pdfchronic obstructive pulmonary diseaseacute exacerbationpathogendrug resistance
spellingShingle Hyun Woo Ji
Soojoung Yu
Yun Su Sim
Hyewon Seo
Jeong-Woong Park
Kyung Hoon Min
Deog Kyeom Kim
Hyun Woo Lee
Chin Kook Rhee
Yong Bum Park
Kyeong-Cheol Shin
Kwang Ha Yoo
Ji Ye Jung
Clinical Significance of Various Pathogens Identified in Patients Experiencing Acute Exacerbations of COPD: A Multi-center Study in South Korea
Tuberculosis and Respiratory Diseases
chronic obstructive pulmonary disease
acute exacerbation
pathogen
drug resistance
title Clinical Significance of Various Pathogens Identified in Patients Experiencing Acute Exacerbations of COPD: A Multi-center Study in South Korea
title_full Clinical Significance of Various Pathogens Identified in Patients Experiencing Acute Exacerbations of COPD: A Multi-center Study in South Korea
title_fullStr Clinical Significance of Various Pathogens Identified in Patients Experiencing Acute Exacerbations of COPD: A Multi-center Study in South Korea
title_full_unstemmed Clinical Significance of Various Pathogens Identified in Patients Experiencing Acute Exacerbations of COPD: A Multi-center Study in South Korea
title_short Clinical Significance of Various Pathogens Identified in Patients Experiencing Acute Exacerbations of COPD: A Multi-center Study in South Korea
title_sort clinical significance of various pathogens identified in patients experiencing acute exacerbations of copd a multi center study in south korea
topic chronic obstructive pulmonary disease
acute exacerbation
pathogen
drug resistance
url http://e-trd.org/upload/pdf/trd-2024-0089.pdf
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