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Viral and bacterial infection in acute asthma and chronic obstructive pulmonary disease increases the risk of readmission
Author(s) -
Wark Peter A.B.,
Tooze Melinda,
Powell Heather,
Parsons Kristy
Publication year - 2013
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/resp.12099
Subject(s) - medicine , copd , rhinovirus , asthma , virus , sputum , exacerbation , respiratory system , immunology , tuberculosis , pathology
Background and objective Infection is as an important trigger for acute asthma and chronic obstructive pulmonary disease ( COPD ). The aim of this article was to determine the prevalence and impact of virus and bacterial infections in acute asthma and COPD . Methods Subjects were recruited, within 24 h of hospital admission for acute exacerbations of asthma and COPD . Nose/throat swabs and sputum samples were collected and examined by multiplex polymerase chain reaction for respiratory viruses and cultured for bacteria. The primary outcomes were length of stay ( LOS ) and readmission to hospital within 60 days. Results A total of 199 subjects were recruited (96 had asthma and 103 COPD ) for 235 events (36 re‐presented). A virus was detected in 79 subjects (40%), bacteria in 41 (21%), and of these, 18 had both. Rhinovirus A was the most frequently isolated virus. A multivariate analysis was performed to control for confounders. It found that detection of a virus, a virus and bacteria, forced expiratory volume in 1 s (FEV 1 ) and a diagnosis of COPD were all independent predictors of prolonged LOS , while risk of readmission within 60 days was increased with virus infection alone, virus and bacterial infection, lower FEV 1 and current smoking. Conclusions Virus infection, especially in the presence of chronic bacterial infection, is an important determinant of more severe acute exacerbations in both asthma and COPD , and patients with co‐infections are more likely to be readmitted to hospital following their exacerbation.