Efect of bacterial infection on airway inflammation in acute exacerbation of chronic obstructive pulmonary disease patients_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

JIANG Xin ¹ , WANG Guifang ² , QIAN Jianmei ³ ,  BAI Chunxlze ²

Clinical Medical College，Changzheng Hospital，Second Military Medical University．Shanghai，200003，China Correspondece author：BAI Chun—xue，E—maiZ：drcxbai—zshospital@ 126．com;

Corresponding author：

BAI Chunxlze, Email: drcxbai-zshospital@126.com

Keywords：

Chronic obstructive pulmonary disease; Acute exacerbation; Bacterial infection; Airway inflammation

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0bjective To study the effect of bacterial infection on acute exacerbation of chronic obstructive pulmonary disease(AECOPD)，and to compare the airway inflammation caused by different isolated bacteria．Methods A total of 159 sputum samples were collected from AECOPD patients diagnosed according to GOLD 2004 standard，in which conventional culture and identification of bacteria was conducted．The patients with purulent sputa were divided into different groups according to bacteria separated．Levels of IL-6．IL-8 and TNF-α in sputum supernatant were assayed and compared in different bacteria groups．the purulent sputum without isolated bacteria group(NG)and normal control group(NC)． Results One hundred and twenty-nine strains of bacteria were isolated in 159 qualified sputa，including 26 strains of Klebsiella pneumoniae(KB)，21 strains of Hemophilus influenza(Hi)，17 strains of Pseudomonas aeruginosa(PA)，37 strains of Haemophilus parainflb~enzae(HP)(mixed infection not included)and 28 strains of other bacteria．Among of all samples，20 were double infection of Haernophilus parainfluenzae with another bacterium．Ninety-seven purulent sputa were collected．According to bacteria isolated，these sputa were divided into five groups，named HP(24 samples)，Hi(20 samples)，PA(16 samples)，KB(19 samples)and NG(18 samples)．Contrast to NC，concentration of IL-8 and TNF-α rose in sputa from which PA，Hi，KB were isolated(P lt;0．05)．The level increased much more in sputa from which PA and Hi were isolated compared with KB(P lt;0．05)．Concentration of IL-6 rose in sputa of each group collected from AECOPD patients contrast to sputa collected from NC(P lt;0．05)，without significant differences among all other group except for NC．Conclusions Bacterial infection plays an important role in AECOPD characterized with high level of inflammatory factors especially when PA，Hi，KB were infected bacteria．This study provides evidence for antibacterial therapy in AECOPD patients．

Citation： JIANG Xin ,WANG Guifang,QIAN Jianmei,BAI Chunxlze. Efect of bacterial infection on airway inflammation in acute exacerbation of chronic obstructive pulmonary disease patients. Chinese Journal of Respiratory and Critical Care Medicine, 2008, 08(6): 416-420. doi: Copy

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2.	Nseir S，Di Pompeo C，Cavestri B，et al．Multiple—diaig-resistant bac— teria in patients with severe acute exacerbation of chronic obstructive pulmonary disease：Prevalence，risk factors，and outcome．Crit Care Med．2006．34：2959-2966.
3.	Diederen BM ，van der Valk PD，Kluytmans JA，et a1．The role of a— typical respiratory pathogens in exacerbations of chronic obstructive pulmonary disease．Eur Respir J，2007，30：240·244.
4.	Cameron RJ，de Wit D，Welsh TN，et a1．Virus infection in exacerbations of chronic obstructive pulmonary disease requiring ventila— tion．Intensive Care Med，2006，32：1022-1029.
5.	Global Initiative for Chronic Obstructive Lung Disease(GOLD) Global strategy for the diagnosis，management，and prevention of chronic obstructive pulmonary disease：updated 2004．NHLBI／WHO workshop report．Bethesda，MD：US Department of Health and Human Services，2004，National Institutes of Health publication No．2701.
6.	Bach PB，Brown C，Gelfand SE，et al．Management of acute exacerbations of chronic obstructive pulmonary disease：a summary and appraisal of published evidence．Ann Intern Med，2001，134：600-620.
7.	Bhowmik A，Seemungal TAR，Sapsford RJ，et a1．Comparision of spontaneous and induced sputum for investigation of airway inflam— marion in chronic obstructive pulmonary disease．Thorax，1998，53： 953-956.
8.	修清玉，方正，赖国祥，等．改良流感嗜血杆菌培养基的实验研究与评价．中华医学检验杂志，1998，21：161-163. 9 Kolls WE，Bannerman TL Staphylococcus and Micrococcus．In： Mrrry PR，Baron EJ，Pfalier MA，et a1．Mannual of clinical microbiology， 7th ed．Washington DC．American Society of Microbiology ， 1999，264-282.
9.	Khair OA。Davies RJ，Devalia JL Bacterial induced release of in. flammatory mediators by bronchial epithelial cells．Eur Respir J， 1996，9：1913-1922.
10.	曾勉，关开泮，黄晓梅，等．慢性阻塞性肺疾病患者诱导痰促炎／抗炎介质水平的变化．中国呼吸与危重监护杂志，2007，6：373.
11.	Sethi S，Musearella K，Evans N，et at．Airway inflammation and aetiology of acute exacerbations of chronic bronchitis．Chest，2000，1 1 8： 1557．1565.
12.	Hill AT，Campbell EJ，Hill SL，et a1．Association between airway bacterial load and markers of airway inflammation in patients with stable chronic bronchitis．Am J Med，2000，109：288-295.
13.	Seemungal TA，Harper-Owen R，Bhowmik A，et a1．Detection of rhinovirus in induced sputum at exacerbation of chronic obstructive pulmonary disease．Eur Respir J，2000，16：677-683．.
14.	.

1. Parker CM ，Voduc N，Aaron SD，et al.Physiological changes during symptom recovery from moderate exacerbations of COPD．Eur Respir J，2005，26：420428.
2. Nseir S，Di Pompeo C，Cavestri B，et al．Multiple—diaig-resistant bac— teria in patients with severe acute exacerbation of chronic obstructive pulmonary disease：Prevalence，risk factors，and outcome．Crit Care Med．2006．34：2959-2966.
3. Diederen BM ，van der Valk PD，Kluytmans JA，et a1．The role of a— typical respiratory pathogens in exacerbations of chronic obstructive pulmonary disease．Eur Respir J，2007，30：240·244.
4. Cameron RJ，de Wit D，Welsh TN，et a1．Virus infection in exacerbations of chronic obstructive pulmonary disease requiring ventila— tion．Intensive Care Med，2006，32：1022-1029.
5. Global Initiative for Chronic Obstructive Lung Disease(GOLD) Global strategy for the diagnosis，management，and prevention of chronic obstructive pulmonary disease：updated 2004．NHLBI／WHO workshop report．Bethesda，MD：US Department of Health and Human Services，2004，National Institutes of Health publication No．2701.
6. Bach PB，Brown C，Gelfand SE，et al．Management of acute exacerbations of chronic obstructive pulmonary disease：a summary and appraisal of published evidence．Ann Intern Med，2001，134：600-620.
7. Bhowmik A，Seemungal TAR，Sapsford RJ，et a1．Comparision of spontaneous and induced sputum for investigation of airway inflam— marion in chronic obstructive pulmonary disease．Thorax，1998，53： 953-956.
8. 修清玉，方正，赖国祥，等．改良流感嗜血杆菌培养基的实验研究与评价．中华医学检验杂志，1998，21：161-163. 9 Kolls WE，Bannerman TL Staphylococcus and Micrococcus．In： Mrrry PR，Baron EJ，Pfalier MA，et a1．Mannual of clinical microbiology， 7th ed．Washington DC．American Society of Microbiology ， 1999，264-282.
9. Khair OA。Davies RJ，Devalia JL Bacterial induced release of in. flammatory mediators by bronchial epithelial cells．Eur Respir J， 1996，9：1913-1922.
10. 曾勉，关开泮，黄晓梅，等．慢性阻塞性肺疾病患者诱导痰促炎／抗炎介质水平的变化．中国呼吸与危重监护杂志，2007，6：373.
11. Sethi S，Musearella K，Evans N，et at．Airway inflammation and aetiology of acute exacerbations of chronic bronchitis．Chest，2000，1 1 8： 1557．1565.
12. Hill AT，Campbell EJ，Hill SL，et a1．Association between airway bacterial load and markers of airway inflammation in patients with stable chronic bronchitis．Am J Med，2000，109：288-295.
13. Seemungal TA，Harper-Owen R，Bhowmik A，et a1．Detection of rhinovirus in induced sputum at exacerbation of chronic obstructive pulmonary disease．Eur Respir J，2000，16：677-683．.
14. .

Chinese Journal of Respiratory and Critical Care Medicine

Efect of bacterial infection on airway inflammation in acute exacerbation of chronic obstructive pulmonary disease patients

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