Diederen B M W, van der Valk P D L P M, Kluytmans J A W J, Peeters M F, Hendrix R
Regional Laboratory of Public Health Haarlem, Boerhaavelaan 26, 2035 RC, Haarlem, The Netherlands.
Eur Respir J. 2007 Aug;30(2):240-4. doi: 10.1183/09031936.00012707. Epub 2007 Apr 25.
The aetiology of acute exacerbations of chronic obstructive pulmonary disease (COPD) is heterogeneous and still under discussion. Serological studies have suggested that Mycoplasma pneumoniae, Chlamydia pneumoniae and Legionella pneumophila may play a role in acute exacerbations of COPD. The presence of these atypical pathogens in sputum samples was investigated in patients with stable COPD and with acute exacerbations of COPD using real-time PCR. The present study was part of a randomised, double-blind, single-centre study and a total of 248 sputum samples from 104 COPD patients were included. In total, 122 samples obtained during stable disease (stable-state sputa) and 126 samples obtained during acute exacerbations of COPD (exacerbation sputa) were tested. Of the 122 stable-state sputa, all samples were negative for M. pneumoniae and C. pneumoniae DNA, whereas one sample was positive for Legionella non-pneumophila DNA. Of the 126 exacerbation sputa, all samples were negative for M. pneumoniae and C. pneumoniae DNA, whereas one sample was positive for Legionella non-pneumophila DNA. The possible relationship between the presence of atypical pathogens and the aetiology of acute exacerbations in chronic obstructive pulmonary disease was investigated in patients with stable disease and in those with acute exacerbations using real-time PCR. No indication was found of a role for Legionella spp., Chlamydia pneumoniae or Mycoplasma pneumoniae in stable, moderately severe chronic obstructive pulmonary disease and in its exacerbations.
慢性阻塞性肺疾病（COPD）急性加重的病因具有异质性，仍在讨论之中。血清学研究表明，肺炎支原体、肺炎衣原体和嗜肺军团菌可能在COPD急性加重中起作用。使用实时聚合酶链反应（PCR）对稳定期COPD患者和COPD急性加重患者痰液样本中这些非典型病原体的存在情况进行了调查。本研究是一项随机、双盲、单中心研究的一部分，共纳入了104例COPD患者的248份痰液样本。总共检测了122份在疾病稳定期获得的样本（稳定期痰液）和126份在COPD急性加重期获得的样本（加重期痰液）。在122份稳定期痰液中，所有样本的肺炎支原体和肺炎衣原体DNA均为阴性，而1份样本的非嗜肺军团菌DNA呈阳性。在126份加重期痰液中，所有样本的肺炎支原体和肺炎衣原体DNA均为阴性，而1份样本的非嗜肺军团菌DNA呈阳性。使用实时PCR对稳定期疾病患者和急性加重期患者中非典型病原体的存在与慢性阻塞性肺疾病急性加重病因之间的可能关系进行了研究。未发现嗜肺军团菌属、肺炎衣原体或肺炎支原体在稳定的中度严重慢性阻塞性肺疾病及其加重期起作用的迹象。
