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C-reactive protein level and microbial aetiology in patients hospitalised with acute exacerbation of COPD.

C-reactive protein level and microbial aetiology in patients hospitalised with acute exacerbation of COPD.
C-reactive protein level and microbial aetiology in patients hospitalised with acute exacerbation of COPD.
Both viruses and bacteria are thought to cause exacerbations of chronic obstructive pulmonary disease (COPD); however, the relative importance of each remains uncertain. C-reactive protein (CRP) levels increase during exacerbations but the relationship with aetiology is not established. We aimed to explore the relationship between serum CRP and the rate of detection of viruses and bacteria. This was a prospectively recruited, observational study of patients hospitalised with exacerbations of COPD. Nasopharyngeal swabs were tested for respiratory viruses by reverse transcriptase-PCR. Sputum and blood were collected for bacterial culture and urine tested for pneumococcal antigen. CRP levels were measured on sera. CRP and other factors associated with viral, bacterial or mixed detection were assessed using multiple logistic regression analysis. 264 patients with exacerbations of COPD were studied: 26% tested positive for respiratory viruses only, 13% had bacteria only, 12% had mixed viral/bacterial detection, and 49% had no pathogens detected. CRP level and temperature were strongly associated with viral detection rate (p<0.001 and p=0.004, respectively) and mixed viral/bacterial detection rate (p=0.02 and p=0.03, respectively) on multivariate analysis. Bacterial detection rate was not associated with CRP level or body temperature. This study supports the role of viruses as important aetiological agents causing exacerbations of COPD.
0903-1936
76-86
Clark, Tristan W.
712ec18e-613c-45df-a013-c8a22834e14f
Medina, Marie-Jo
651f91ae-0995-459f-baa1-c3b4978adc25
Batham, Sally
271a3b6b-495c-4aca-8e68-f13f10f10394
Curran, Martin D.
f8d611e4-a2f5-4720-8a0a-b030a13784ab
Parmar, Surendra
191a5173-cfed-4c07-bee7-53c7902b7bf8
Nicholson, Karl G.
27948033-015f-4e4f-a8ed-1df896b42b0a
Clark, Tristan W.
712ec18e-613c-45df-a013-c8a22834e14f
Medina, Marie-Jo
651f91ae-0995-459f-baa1-c3b4978adc25
Batham, Sally
271a3b6b-495c-4aca-8e68-f13f10f10394
Curran, Martin D.
f8d611e4-a2f5-4720-8a0a-b030a13784ab
Parmar, Surendra
191a5173-cfed-4c07-bee7-53c7902b7bf8
Nicholson, Karl G.
27948033-015f-4e4f-a8ed-1df896b42b0a

Clark, Tristan W., Medina, Marie-Jo, Batham, Sally, Curran, Martin D., Parmar, Surendra and Nicholson, Karl G. (2015) C-reactive protein level and microbial aetiology in patients hospitalised with acute exacerbation of COPD. European Respiratory Journal, 45 (1), 76-86. (doi:10.1183/09031936.00092214). (PMID:25186260)

Record type: Article

Abstract

Both viruses and bacteria are thought to cause exacerbations of chronic obstructive pulmonary disease (COPD); however, the relative importance of each remains uncertain. C-reactive protein (CRP) levels increase during exacerbations but the relationship with aetiology is not established. We aimed to explore the relationship between serum CRP and the rate of detection of viruses and bacteria. This was a prospectively recruited, observational study of patients hospitalised with exacerbations of COPD. Nasopharyngeal swabs were tested for respiratory viruses by reverse transcriptase-PCR. Sputum and blood were collected for bacterial culture and urine tested for pneumococcal antigen. CRP levels were measured on sera. CRP and other factors associated with viral, bacterial or mixed detection were assessed using multiple logistic regression analysis. 264 patients with exacerbations of COPD were studied: 26% tested positive for respiratory viruses only, 13% had bacteria only, 12% had mixed viral/bacterial detection, and 49% had no pathogens detected. CRP level and temperature were strongly associated with viral detection rate (p<0.001 and p=0.004, respectively) and mixed viral/bacterial detection rate (p=0.02 and p=0.03, respectively) on multivariate analysis. Bacterial detection rate was not associated with CRP level or body temperature. This study supports the role of viruses as important aetiological agents causing exacerbations of COPD.

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More information

Accepted/In Press date: 2 August 2014
e-pub ahead of print date: 3 September 2014
Published date: 1 January 2015
Organisations: Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 386393
URI: https://eprints.soton.ac.uk/id/eprint/386393
ISSN: 0903-1936
PURE UUID: 742c43fd-80f6-48f8-88c2-edbff050a28c
ORCID for Tristan W. Clark: ORCID iD orcid.org/0000-0001-6026-5295

Catalogue record

Date deposited: 01 Feb 2016 11:54
Last modified: 06 Jun 2018 12:23

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Contributors

Author: Marie-Jo Medina
Author: Sally Batham
Author: Martin D. Curran
Author: Surendra Parmar
Author: Karl G. Nicholson

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