Taddei Laura, Malvisi Lucio, Hui David S, Malvaux Ludovic, Samoro Ronnie Z, Lee Sang Haak, Yeung Yiu Cheong, Liu Yu-Chih, Arora Ashwani Kumar
GSK, Siena, Italy.
These authors contributed equally.
ERJ Open Res. 2022 Sep 26;8(3). doi: 10.1183/23120541.00057-2022. eCollection 2022 Jul.
The burden of chronic obstructive pulmonary disease (COPD) in the Asia-Pacific region is projected to increase. Data from other regions show bacterial and viral infections can trigger acute exacerbations of COPD (AECOPD).
This 1-year prospective epidemiological study (ClinicalTrials.gov identifier: NCT03151395) of patients with moderate to very severe COPD in Hong Kong, the Philippines, South Korea and Taiwan assessed the prevalence in sputum samples (by culture and PCR) of bacterial and viral pathogens during stable COPD and AECOPD. The odds of experiencing an exacerbation was evaluated for pathogen presence, acquisition and apparition. Health-related quality of life (HRQOL) was assessed.
197 patients provided 983 sputum samples, with 226 provided during exacerbation episodes. The mean yearly AECOPD incidence rate was 1.27 per patient. The most prevalent bacteria by PCR at exacerbation were (Hi) and (Mcat); Mcat prevalence was higher at exacerbation than at stable state. Virus prevalence was low, other than for human rhinovirus (HRV) (8.1%, stable state; 16.6%, exacerbation). The odds ratio (95% CI) for an exacerbation ( stable state) was statistically significant for the presence, acquisition and apparition of Hi (2.20, 1.26-3.89; 2.43, 1.11-5.35; 2.32, 1.20-4.46, respectively), Mcat (2.24, 1.30-3.88; 5.47, 2.16-13.86; 3.45, 1.71-6.98, respectively) and HRV (2.12, 1.15-3.91; 2.22, 1.09-4.54; 2.09, 1.11-3.91, respectively). HRQOL deteriorated according to the number of exacerbations experienced.
In patients with COPD in the Asia-Pacific region, the presence of Hi, Mcat or HRV in sputum samples significantly increased the odds of an exacerbation, providing further evidence of potential roles in triggering AECOPD.
预计慢性阻塞性肺疾病（COPD）在亚太地区的负担将会增加。其他地区的数据显示，细菌和病毒感染可引发慢性阻塞性肺疾病急性加重（AECOPD）。
这项针对中国香港、菲律宾、韩国和中国台湾地区中重度至极重度慢性阻塞性肺疾病患者开展的为期1年的前瞻性流行病学研究（ClinicalTrials.gov标识符：NCT03151395），评估了稳定期慢性阻塞性肺疾病和慢性阻塞性肺疾病急性加重期痰样本中（通过培养和聚合酶链反应）细菌和病毒病原体的患病率。评估了病原体存在、获得和出现时发生急性加重的几率。对健康相关生活质量（HRQOL）进行了评估。
197例患者提供了983份痰样本，其中226份是在急性加重期提供的。患者的年慢性阻塞性肺疾病急性加重平均发病率为每人1.27次。急性加重期通过聚合酶链反应检测到的最常见细菌为嗜麦芽窄食单胞菌（Mcat）和流感嗜血杆菌（Hi）；Mcat在急性加重期的患病率高于稳定期。除人鼻病毒（HRV）外，病毒患病率较低（稳定期为8.1%；急性加重期为16.6%）。对于Hi、Mcat和HRV的存在、获得和出现，急性加重（相对于稳定期）的比值比（95%CI）具有统计学意义（Hi分别为2.20，1.26 - 3.89；2.43，1.11 - 5.35；2.32，1.20 - 4.46；Mcat分别为2.24，1.30 - 3.88；5.47，2.16 - 13.86；3.45，1.71 - 6.98；HRV分别为2.12，1.15 - 3.91；2.22，1.09 - 4.54；2.09，1.11 - 3.91）。健康相关生活质量根据急性加重次数而恶化。
在亚太地区慢性阻塞性肺疾病患者中，痰样本中Hi、Mcat或HRV的存在显著增加了急性加重的几率，为其在引发慢性阻塞性肺疾病急性加重中的潜在作用提供了进一步证据。
