Use of serology and polymerase chain reaction to detect atypical respiratory pathogens during acute exacerbation of chronic obstructive pulmonary disease.
- Author:
Chi Young JUNG
1
;
Yeoung Hun CHOE
;
Sang Yeub LEE
;
Woo Jin KIM
;
Jong Deog LEE
;
Seung Won RA
;
Eu Gene CHOI
;
Jae Seung LEE
;
Myung Jae PARK
;
Ju Ock NA
Author Information
- Publication Type:Multicenter Study ; Randomized Controlled Trial ; Original Article
- Keywords: Pulmonary disease, chronic obstructive; Exacerbation; Atypical pathogen; Serology; Polymerase chain reaction
- MeSH: Ambulatory Care Facilities; Chlamydophila pneumoniae; DNA; Enzyme-Linked Immunosorbent Assay; Humans; Immunoglobulin G; Immunoglobulin M; Korea; Legionella pneumophila; Multiplex Polymerase Chain Reaction; Mycoplasma pneumoniae; Pneumonia; Pneumonia, Mycoplasma; Polymerase Chain Reaction*; Pulmonary Disease, Chronic Obstructive*; Serologic Tests; Sputum
- From:The Korean Journal of Internal Medicine 2018;33(5):941-951
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: To use serological and multiplex polymerase chain reaction (PCR) assays to examine sputum samples from patients experiencing acute exacerbation of chronic obstructive pulmonary disease (AECOPD) for the presence of atypical pathogens, including Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella pneumophila. METHODS: From September 2012 to February 2014, 341 patients with AECOPD attending outpatient clinics were enrolled as part of a randomized, double-blind, multicenter study. A commercial enzyme-linked immunosorbent assay was used to measure serum immunoglobulin M (IgM) and IgG antibody titers on the first day of the study and at 36 days post-enrollment. Multiplex PCR was used to test sputum samples for the presence of atypical pathogens. A urinary antigen test for L. pneumophila was performed on the first day. RESULTS: Nineteen patients (5.6%) showed serological evidence of acute infection with M. pneumoniae. Also, one and seven patients (2%) showed serological evidence of acute infection with C. pneumoniae and L. pneumophila, respectively. All DNA samples were negative for M. pneumoniae, C. pneumoniae, and L. pneumophila according to PCR. Only one urine sample was positive for L. pneumophila antigen, but serologic evidence was lacking. CONCLUSIONS: Serological testing suggested that infection by atypical pathogens during AECOPD was relatively uncommon. In addition, PCR provided no direct evidence of infection by atypical pathogens. Thus, atypical pathogens may not be a major cause of AECOPD in South Korea.
