Use of serology and polymerase chain reaction to detect atypical respiratory pathogens during acute exacerbation of chronic obstructive pulmonary disease

Chi Young Jung, 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

Research output: Contribution to journalArticle

1 Citation (Scopus)

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.

Original languageEnglish
Pages (from-to)941-951
Number of pages11
JournalKorean Journal of Internal Medicine
Volume33
Issue number5
DOIs
Publication statusPublished - 2018 Sep 1

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Legionella pneumophila
Serology
Chlamydophila pneumoniae
Mycoplasma pneumoniae
Chronic Obstructive Pulmonary Disease
Polymerase Chain Reaction
Multiplex Polymerase Chain Reaction
Infection
Sputum
Republic of Korea
Ambulatory Care Facilities
Double-Blind Method
Multicenter Studies
Immunoglobulin M
Immunoglobulin G
Enzyme-Linked Immunosorbent Assay
Urine
Antigens
Antibodies
DNA

Keywords

  • Atypical pathogen
  • Chronic obstructive
  • Exacerbation
  • Polymerase chain reaction
  • Pulmonary disease
  • Serology

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Use of serology and polymerase chain reaction to detect atypical respiratory pathogens during acute exacerbation of chronic obstructive pulmonary disease. / Jung, Chi Young; Choe, Yeoung Hun; Lee, Sang Yeub; Kim, Woo Jin; Lee, Jong Deog; Ra, Seung Won; Choi, Eu Gene; Lee, Jae Seung; Park, Myung Jae; Na, Ju Ock.

In: Korean Journal of Internal Medicine, Vol. 33, No. 5, 01.09.2018, p. 941-951.

Research output: Contribution to journalArticle

Jung, Chi Young ; Choe, Yeoung Hun ; Lee, Sang Yeub ; Kim, Woo Jin ; Lee, Jong Deog ; Ra, Seung Won ; Choi, Eu Gene ; Lee, Jae Seung ; Park, Myung Jae ; Na, Ju Ock. / Use of serology and polymerase chain reaction to detect atypical respiratory pathogens during acute exacerbation of chronic obstructive pulmonary disease. In: Korean Journal of Internal Medicine. 2018 ; Vol. 33, No. 5. pp. 941-951.
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AU - Choe, Yeoung Hun

AU - Lee, Sang Yeub

AU - Kim, Woo Jin

AU - Lee, Jong Deog

AU - Ra, Seung Won

AU - Choi, Eu Gene

AU - Lee, Jae Seung

AU - Park, Myung Jae

AU - Na, Ju Ock

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AB - 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.

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KW - Exacerbation

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