Acute Purulent Exacerbation of Chronic Obstructive Pulmonary Disease andChlamydia pneumoniaeInfection

Abstract

In order to investigate the role of bacteria, including Mycoplasma pneumoniae and especially Chlamydia pneumoniae in acute purulent exacerbations of chronic obstructive pulmonary disease (COPD), we examined sputum specimens and acute and convalescent sera taken 26 d apart from 49 outpatients experiencing an acute purulent exacerbation of COPD. The sera were tested for antibodies to C. pneumoniae with the microimmunofluorescence test, and for antibodies to M. pneumoniae with the indirect fluorescence antibody test. Routine microbiologic culture of sputum yielded potentially pathogenic microorganisms in 12 of the 49 patients (24%). Three patients (6%) showed serologic evidence of recent M. pneumoniae infection. Seven patients showed high IgG titers of >/= 1:1,024 to C. pneumoniae, and an additional four had a fourfold increase in IgG titer, suggesting reinfection with C. pneumoniae. Sputum from two of these 11 patients also grew Streptococcus pneumoniae, and one grew Moraxella catarrhalis. Patients with and without serologic evidence of current C. pneumoniae infection showed no significant differences in clinical features or pulmonary function. The high incidence of infection with C. pneumoniae (the sole causal agent in 16% of cases, and the causal agent with other agents in 6%) provides insight into the importance of this organism among agents leading to exacerbations of COPD in Turkey.

The role of atypical respiratory pathogens in exacerbations of chronic obstructive pulmonary disease

“…The term ''atypical pathogen'' most commonly refers to Mycoplasma pneumoniae, Chlamydia pneumoniae and Legionella pneumophila. AECOPD [7][8][9][10][11][12][13][14][15][16][17]. However, the interpretation of the role of these atypical pathogens in AECOPD is not easy, since these organisms are difficult to cultivate from respiratory tract specimens.…”

Current Status of the Mollicute (Mycoplasma) Lung Disease: Pathogenesis, Diagnostics, Treatment and Prevention

“…Since late 1970's, several authors suggested a relationship between COPD and M. pneumoniae infection [Buscho et al, 1978;Gump et al, 1976;Smith et al, 1980], but it was until late 1990's and early 2000's that several studies based on serology brought attention once more on this issue. [Lieberman et al, 2001[Lieberman et al, , 2002Mogulkoc et al, 1999]. It is well known that mycoplasmas species pathogenic for humans have the ability to induce chronic disease states in which clearance of the bacteria is extremely difficult.…”

Pathogen-directed Therapy in Acute Exacerbations of Chronic Obstructive Pulmonary Disease

“…Based on IgG and IgM antibody titers, C. pneumoniae has been reported as an etiologic factor in 4 to 34% of AE-COPDs (87)(88)(89)(90)(91). Disparities in reported rates likely relate to differences in serologic methods used to identify C. pneumoniae infection and in the prevalence of infection reported in patients with stable COPD disease (92).…”

“…Disparities in reported rates likely relate to differences in serologic methods used to identify C. pneumoniae infection and in the prevalence of infection reported in patients with stable COPD disease (92). By contrast, M. pneumoniae has been identified in only a minority (,1-14%) of AE-COPDs (71,89,93,94).…”