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Published online before print April 25, 2007
Eur Respir J 2007, doi:10.1183/09031936.00012707
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ORIGINAL ARTICLE

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

B.M.W. Diederen 1*, P.D.L.P.M. van der Valk 2, J.A.W.J. Kluytmans 3, M.F. Peeters 1, R. Hendrix 4

1 Laboratory for Medical Microbiology and Immunology, St. Elisabeth Hospital, The Netherlands
2 Dept of Pulmonary Medicine, Medisch Spectrum Twente, Enschede, The Netherlands
3 Laboratory for Microbiology and Infection Control, Amphia Hospital, Breda, The Netherlands; and Dept of Medical Microbiology and Infection Control, VU Medical University, Amsterdam, The Netherlands
4 Regional Laboratory of Public Health, Enschede, The Netherlands

* To whom correspondence should be addressed. E-mail: bramdiederen{at}gmail.com.


  Abstract

The aetiology of acute exacerbations in COPD (AECOPD) is heterogeneous and still under discussion. Serological studies have suggested that Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella pneumophila may play a role in AECOPD.

We investigated the presence of these atypical pathogens in sputum samples in patients with stable COPD and those with AECOPD using real-time PCR. This 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 stable state sputa and 126 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.

We investigated the possible relationship between presence of atypical pathogens in patients with stable COPD and in those with AECOPD using real-time PCR and found no indication for a role of Legionella spp, C. pneumoniae or M. pneumoniae in stable moderately severe COPD and in its exacerbations.

Keywords:  Atypical pathogens, COPD, C. pneumoniae, exacerbation, Legionella, M. pneumoniae, PCR, real-time




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