PURPOSE: Use of nucleic acid amplification techniques has increased the identification rate for respiratory viruses(RV)in adult patients with respiratory infections. The objectives of the study were to identify RV in patients with acute exacerbation of COPD (AECOPD) using three different sampling methods and to compare virus proportions and types in this population with three comparison groups.
METHODS: The study population included 66 hospitalized adult patients with febrile non-pneumonic AECOPD. The three comparison adult non-COPD groups consisted of 183 community-acquired pneumonia (CAP)patients, 450 control subjects and 201 patients with non-pneumonic lower respiratory tract infection (NPLRTI), sampled during the same time period. Each participant was sampled by oropharyngeal swab, nasopharyngeal swab, and nasopharyngeal washing and the samples were tested for detection of 12 RV by multiplex TaqMan probe-based real time PCR (mqRT-PCR).
RESULTS: At least one RV was identified in 22 AECOPD patients (33.3%) compared to 58 CAP patients (31.7%), 32 control subjects (7.1%) and 104 NPLRTI patients (51.7%) (NS, P< 0.000001 and P< 0.0001, respectively). In one patient two RV were identified. Coronaviruses were identified in 9 AECOPD patients (13.6%), influenza viruses in 7 (10.6%), rhinovirus in 4 (6.0%), human metapneumovirus (hMPV) in 2 (3.0%) and parainfluenza 3 virus in 1 patient (1.5%).
CONCLUSION: The RV proportion involved in AECOPD is higher that previously reported, and is near the proportion in non-COPD CAP patients.
CLINICAL IMPLICATIONS: The results of this study highlight the need to develop effective antiviral agents for all types of RV.
DISCLOSURE: David Lieberman, No Financial Disclosure Information; No Product/Research Disclosure Information