The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Use of serology and polymerase chain reaction to detect atypical respiratory pathogens during acute exacerbation of chronic obstructive pulmonary disease

  • Jung, Chi Young (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Daegu Catholic University Medical Center) ;
  • Choe, Yeoung Hun (Division of Pulmonology and Allergology, Department of Internal Medicine, Chonbuk National University Hospital) ;
  • Lee, Sang Yeub (Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Korea University College of Medicine) ;
  • Kim, Woo Jin (Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Kangwon National University School of Medicine) ;
  • Lee, Jong Deog (Division of Pulmonology, Department of Internal Medicine, Gyeongsang National University School of Medicine) ;
  • Ra, Seung Won (Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Ulsan University Hospital) ;
  • Choi, Eu Gene (Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Daejeon Hankook Hospital) ;
  • Lee, Jae Seung (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Park, Myung Jae (Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Kyung Hee University Hospital) ;
  • Na, Ju Ock (Division of Pulmonology, Department of Internal Medicine, Soonchunhyang University College of Medicine)
  • Received : 2017.08.11
  • Accepted : 2018.01.02
  • Published : 2018.09.01
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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.

Keywords

Acknowledgement

Supported by : Soonchunhyang University

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