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Impact of bacterial strain acquisition in the lung of patients with COPD: the AERIS study

Impact of bacterial strain acquisition in the lung of patients with COPD: the AERIS study
Impact of bacterial strain acquisition in the lung of patients with COPD: the AERIS study

BACKGROUND: Bacterial infections are associated with acute exacerbations of chronic obstructive pulmonary disease (AECOPD), but the mechanism is incompletely understood.

METHOD: In a COPD observational study (NCT01360398), sputum samples were collected monthly at the stable state and exacerbation. Post-hoc analyses of 1307 non-typeable Haemophilus influenzae (NTHi) isolates from 20 patients and 756 Moraxella catarrhalis isolates from 38 patients in one year of follow-up were conducted by multilocus sequence typing (MLST). All isolates came from cultured sputum samples that were analyzed for bacterial species presence, apparition (infection not detected at the preceding visit), or acquisition (first-time infection), with the first study visit as a baseline. Strain apparition or new strain acquisition was analyzed by MLST. The odds ratio (OR) of experiencing an exacerbation vs. stable state was estimated by conditional logistic regression modelling, stratified by patient.

RESULTS: The culture results confirmed a significant association with exacerbation only for NTHi species presence (OR 2.28; 95% confidence interval [CI]: 1.12-4.64) and strain apparition (OR 2.38; 95% CI: 1.08-5.27). For M. catarrhalis, although confidence intervals overlapped, the association with exacerbation for first-time species acquisition (OR 5.99; 2.75-13.02) appeared stronger than species presence (OR 3.67; 2.10-6.40), new strain acquisition (OR 2.94; 1.43-6.04), species apparition (OR 4.18; 2.29-7.63), and strain apparition (OR 2.78; 1.42-5.42). This may suggest that previous M. catarrhalis colonization may modify the risk of exacerbation associated with M. catarrhalis infection.

CONCLUSIONS: The results confirm that NTHi and M. catarrhalis infections are associated with AECOPD but suggest different dynamic mechanisms in triggering exacerbations.

Exacerbation, Moraxella catarrhalis, acquisition, apparition, bacteria, non-typeable Haemophilus influenzae
784-793
Malvisi, Lucio
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Yarraguntla, Aparna
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Mortier, Marie-Cecile
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Osman, Karen L
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Cleary, David
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Sente, Beatrice
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Pascal, Thierry G.
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Weynants, Vincent
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Clarke, Stuart
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Taddei, Laura
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Wilkinson, Tom M.A.
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Devaster, Jeanne-Marie
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Devos, Nathalie
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Wootton, Stephen
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Malvisi, Lucio
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Yarraguntla, Aparna
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Mortier, Marie-Cecile
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Osman, Karen L
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Cleary, David
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Sente, Beatrice
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Pascal, Thierry G.
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Weynants, Vincent
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Clarke, Stuart
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Taddei, Laura
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Wilkinson, Tom M.A.
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Devaster, Jeanne-Marie
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Devos, Nathalie
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Wootton, Stephen
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Malvisi, Lucio, Yarraguntla, Aparna, Mortier, Marie-Cecile, Osman, Karen L, Cleary, David, Sente, Beatrice, Pascal, Thierry G., Weynants, Vincent, Clarke, Stuart, Taddei, Laura, Wilkinson, Tom M.A., Devaster, Jeanne-Marie, Devos, Nathalie and Wootton, Stephen (2022) Impact of bacterial strain acquisition in the lung of patients with COPD: the AERIS study. Infectious Diseases, 54 (11), 784-793. (doi:10.1080/23744235.2022.2092648).

Record type: Article

Abstract

BACKGROUND: Bacterial infections are associated with acute exacerbations of chronic obstructive pulmonary disease (AECOPD), but the mechanism is incompletely understood.

METHOD: In a COPD observational study (NCT01360398), sputum samples were collected monthly at the stable state and exacerbation. Post-hoc analyses of 1307 non-typeable Haemophilus influenzae (NTHi) isolates from 20 patients and 756 Moraxella catarrhalis isolates from 38 patients in one year of follow-up were conducted by multilocus sequence typing (MLST). All isolates came from cultured sputum samples that were analyzed for bacterial species presence, apparition (infection not detected at the preceding visit), or acquisition (first-time infection), with the first study visit as a baseline. Strain apparition or new strain acquisition was analyzed by MLST. The odds ratio (OR) of experiencing an exacerbation vs. stable state was estimated by conditional logistic regression modelling, stratified by patient.

RESULTS: The culture results confirmed a significant association with exacerbation only for NTHi species presence (OR 2.28; 95% confidence interval [CI]: 1.12-4.64) and strain apparition (OR 2.38; 95% CI: 1.08-5.27). For M. catarrhalis, although confidence intervals overlapped, the association with exacerbation for first-time species acquisition (OR 5.99; 2.75-13.02) appeared stronger than species presence (OR 3.67; 2.10-6.40), new strain acquisition (OR 2.94; 1.43-6.04), species apparition (OR 4.18; 2.29-7.63), and strain apparition (OR 2.78; 1.42-5.42). This may suggest that previous M. catarrhalis colonization may modify the risk of exacerbation associated with M. catarrhalis infection.

CONCLUSIONS: The results confirm that NTHi and M. catarrhalis infections are associated with AECOPD but suggest different dynamic mechanisms in triggering exacerbations.

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23744235.2022.2092648 - Accepted Manuscript
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e-pub ahead of print date: 6 July 2022
Published date: 2 November 2022
Additional Information: Funding Information: LM, MCM, BS, TGP, VW, LT, JMD, and ND are employed by GSK, and LT, TGP, VW, JMD, and ND hold shares in GSK. VW and JMD are designated inventors on patents owned by GSK. AY was a consultant of ICON for GSK during the conduct of the study and is now employed by GSK. KO received a grant from GSK during the conduct of her Ph.D. DWC reports a grant from GSK during the conduct of this study. SCC received a grant from Pfizer outside of the submitted work and a grant from GSK during the conduct of the study. TMAW has received grants and non-financial support from GSK during the conduct of the study as well as grants from AstraZeneca, Synairgen, and MyMHealth and fees, reimbursement for travel, and meeting attendance from Boehringer Ingelheim, Chiesi, AstraZeneca, Synairgen, and MyMHealth outside of the submitted work. In addition, TMAW has a patent 2018 US Patent 62/479562—Immunogenic Composition, Use and Methods of Treatment—A novel vaccine to prevent exacerbations of COPD pending to GSK and is Founder and Director of MyMHealth Ltd. All authors declare having no other financial and non-financial relationships and activities. Publisher Copyright: © 2022 GlaxoSmithKline Biologicals S.A. Published by Informa UK Limited, trading as Taylor & Francis Group.
Keywords: Exacerbation, Moraxella catarrhalis, acquisition, apparition, bacteria, non-typeable Haemophilus influenzae

Identifiers

Local EPrints ID: 467965
URI: http://eprints.soton.ac.uk/id/eprint/467965
PURE UUID: 72a740be-6a90-4476-830e-ba4b546caf9f
ORCID for David Cleary: ORCID iD orcid.org/0000-0003-4533-0700
ORCID for Stuart Clarke: ORCID iD orcid.org/0000-0002-7009-1548

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Date deposited: 26 Jul 2022 17:10
Last modified: 17 Mar 2024 07:25

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Contributors

Author: Lucio Malvisi
Author: Aparna Yarraguntla
Author: Marie-Cecile Mortier
Author: Karen L Osman
Author: David Cleary ORCID iD
Author: Beatrice Sente
Author: Thierry G. Pascal
Author: Vincent Weynants
Author: Stuart Clarke ORCID iD
Author: Laura Taddei
Author: Tom M.A. Wilkinson
Author: Jeanne-Marie Devaster
Author: Nathalie Devos
Author: Stephen Wootton

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