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Tuberculosis & Respiratory Diseases

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Vol.85 No.1
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A Multicenter Study to Identify the Respiratory Pathogens Associated with Exacerbation of Chronic Obstructive Pulmonary Disease in Korea

Tuberculosis & Respiratory Diseases / Tuberculosis & Respiratory Diseases,
2022, v.85 no.1, pp.37-46
https://doi.org/10.4046/trd.2021.0080
Kwang Ha Yoo, M.D. Ph.D. (Konkuk University School of Medicine)
Hyun Woo Lee, M.D. (Seoul Metropolitan GovernmentSeoul National University Boramae Medical Center, Seoul)
Yun Su Sim, M.D., Ph.D. (Hallym University Kangnam Sacred Heart Hospital, Seoul)
Ji Ye Jung, M.D., Ph.D. (Severance Hospital, Younsei University Health System, Yonsei University College of Medicine, Seoul)
Hyewon Seo, M.D. (Department of Internal Medicine, School of Medicine, Kyungpook National University Hospital,)
Jeong-Woong Park, M.D., Ph.D. (Gachon University Gil Medical Center)
Kyung Hoon Min, M.D., Ph.D. (Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Korea Un)
Jae Ha Lee, M.D., Ph.D. (Department of Internal Medicine, Inje University Haeundae Paik Hospital)
Byung- Keun Kim, M.D., Ph.D (Department of Internal Medicine, Korea University Anam Hospital)
Myung Goo Lee, M.D., Ph.D. (Hallym University Chuncheon Sacred Heart Hospital)
Yeon-Mok Oh, M.D., Ph.D. (Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College)
Seung Won Ra, M.D., Ph.D. (Division of Pulmonary Medicine, Department of Internal Medicine, Ulsan University Hospital)
Tae-Hyung Kim, M.D., Ph.D. (Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri)
Yong Il Hwang, M.D., Ph.D. (Department of Medicine, Hallym University Sacred Heart Hospital)
Chin Kook Rhee, M.D., Ph.D. (The Catholic University of Korea)
Hyonsoo Joo, M.D., Ph.D. (Department of Internal Medicine, Uijeongbu St. Mary’s Hospital)
Eung Gu Lee, M.D. (Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea)
Jin Hwa Lee, M.D., Ph.D. (Ewha Womans University School of Medicine)
Hye Yun Park, M.D., Ph.D. (Department of Medicine, Samsung Medical Center)
Woo Jin Kim, M.D., Ph.D. (Department of Internal Medicine, Kangwon National University School of Medicine)
Soo-Jung Um, M.D., Ph.D. (Department of Internal Medicine, Dong-A University College of Medicine)
Joon Young Choi, M.D., Ph.D. (Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine)
Chang-Hoon Lee, M.D., Ph.D. (Department of Internal Medicine, Seoul National University Hospital, Seoul)
Tai Joon An, M.D. (Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul)
Yeonhee Park, M.D. (Department of Internal Medicine, Daejeon St. Mary’s Hospital)
Young- Soon Yoon, M.D. (Department of Internal Medicine, Dongguk University Ilsan Hospital)
Joo Hun Park, M.D., Ph.D. (Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine)
Deog Kyeom Kim, M.D., Ph.D. (Seoul Metropolitan Government-Seoul National University Boramae Medical Center)
Kwang, H. Y. M. P. , Hyun, W. L. M. , Yun, S. S. M. P. , Ji, Y. J. M. P. , Hyewon, S. M. , Jeong-Woong, P. M. P. , Kyung, H. M. M. P. , Jae, H. L. M. P. , Byung-, K. K. M. P. , Myung, G. L. M. P. , Yeon-Mok, O. M. P. , Seung, W. R. M. P. , Tae-Hyung, K. M. P. , Yong, I. H. M. P. , Chin, K. R. M. P. , Hyonsoo, J. M. P. , Eung, G. L. M. , Jin, H. L. M. P. , Hye, Y. P. M. P. , ... Deog, K. K. M. P. (2022). A Multicenter Study to Identify the Respiratory Pathogens Associated with Exacerbation of Chronic Obstructive Pulmonary Disease in Korea. Tuberculosis & Respiratory Diseases, 85(1), 37-46, https://doi.org/10.4046/trd.2021.0080
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Abstract

Background: Although respiratory tract infection is one of the most important factors triggering acute exacerbation ofchronic obstructive pulmonary disease (AE-COPD), limited data are available to suggest an epidemiologic pattern ofmicrobiology in South Korea. Methods: A multicenter observational study was conducted between January 2015 and December 2018 across28 hospitals in South Korea. Adult patients with moderate-to-severe acute exacerbations of COPD were eligible toparticipate in the present study. The participants underwent all conventional tests to identify etiology of microbialpathogenesis. The primary outcome was the percentage of different microbiological pathogens causing AE-COPD. A comparative microbiological analysis of the patients with overlapping asthma–COPD (ACO) and pure COPD wasperformed. Results: We included 1,186 patients with AE-COPD. Patients with pure COPD constituted 87.9% and those with ACOaccounted for 12.1%. Nearly half of the patients used an inhaled corticosteroid-containing regimen and one-fifth usedsystemic corticosteroids. Respiratory pathogens were found in 55.3% of all such patients. Bacteria and viruses were meldetectedin 33% and 33.2%, respectively. Bacterial and viral coinfections were found in 10.9%. The most frequentlydetected bacteria were Pseudomonas aeruginosa (9.8%), and the most frequently detected virus was influenza A (10.4%). Multiple bacterial infections were more likely to appear in ACO than in pure COPD (8.3% vs. 3.6%, p=0.016). Conclusion: Distinct microbiological patterns were identified in patients with moderate-to-severe AE-COPD in SouthKorea. These findings may improve evidence-based management of patients with AE-COPD and represent the basis forfurther studies investigating infectious pathogens in patients with COPD.

keywords
Symptom Flare Up, Pulmonary Disease, Chronic Obstructive, Microbiology, Bacteriology, Virology

Tuberculosis & Respiratory Diseases

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