The role of viral infections in COPD exacerbations

Aim: The role of viral infections in the exacerbations of chronic obstructive pulmonary disease (COPD) remains controversial. The rates of recent viral infections vary from 23 to 62%; moreover pathogens as Chlamydophila pneumoniae are often detected in patients with COPD during an exacerbation. Investigating the impact of viral infections in COPD exacerbations, a study was conducted in an Athenian hospital of Greece. Patients-Methods: All patients suffered from exacerbation of COPD (n=87), as well as from pneumonia and COPD (n=17).Seventy healthy volunteers were also assessed at the same time (comparison group). In all examinations we measured IgM blood antibodies for influenza A & B, RSV, parainfluenza viruses, Mycoplasma pneumoniae and Chlamydophila pneumoniae. Sputum cultures and bacteria taken from all patients were evaluated if > 105cfu/ml. Results: Sputum cultures revealed bacterial pathogens in a 40% of all patients but still only in three cases these were responsible for the presence of pneumonia. A comparison between patients with exacerbations of COPD and healthy volunteers revealed a statistical increase of IgM for influenza A virus and Mycoplasma pneumoniae. As far as patients with COPD exacerbations were concerned the difference was almost significant for RSV and influenza B but not significant for Chlamydophila pneumoniae. Moreover, there was not detected such a difference between patients with pneumonia and COPD, and patients with COPD exacerbations. Conclusions: The incidence of bacterial colonization in patients with COPD exacerbations attempts to draw the attention of the physician to the prudent use of antibiotics in patients with COPD.