2002 Role of Atypical Pathogens In Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Dr Chili Ming Chee, Princess Margaret Hospital
Abstract
Background
Infection and air pollution are the most common causes of exacerbation in
patients with COrD. Percentage of exacerbation of corD related to
infection by atypical pathogens, namely Mycoplasma pneumoniae,
Chlamydia pneumoniae and Legionella pneumophila, are not clear,
especially in the local setting.
Aim
The aim of the study is to investigate the prevalence of atypical pathogens,
namely Chlamydia pneumoniae, Mycoplasma pneumoniae and Legionella
pneumophila in acute exacerbation of COrD in a major hospital in Hong
Kong.
Methods
This is a prospective cohort study. corD with compatible signs and
symptoms admitted through A&E for exacerbation were recruited. Serum
samples (5 ml of clot blood) for atypical pneumonia titer (Mycoplasma,
Chlamydia, Legionella) were obtained on admission. 2nd blood samples
were collected at 2-4 weeks after admission. 4-fold rise in titer was
considered diagnostic for acute infection. The percentage of exacerbations
caused by atypical pathogens was then analyzed.
Results
88 patients were recruited. 73 patients had complete serological data.
Only 1.4% had evidence of Mycoplasma pneumoniae infection and 1.4%
had evidence of Chlamydia pneumoniae infection. No patient had
evidence of Legionella pneumophila infection.
Conclusion
Results from the present study showed that atypical pathogens are not
common in local patients with COrD exacerbations. Antibiotic coverage
for atypical pathogens for patients with corD exacerbations without
evidence of pneumonia is not warranted.
