The role of Bordetella infections in patients with acute exacerbation of chronic bronchitis
The role of Bordetella infections in patients with acute exacerbation of chronic bronchitis
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DOI：
10.1007/s15010-005-4004-9
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发表时间：
2005-02-01
期刊：
影响因子：
7.5
通讯作者：
Heininger, U
中科院分区：
文献类型：
--
作者：
Bonhoeffer, J;Bär, G;Heininger, U
背景资料：慢性支气管炎急性加重（AECB）与多种病毒和细菌感染因子有关，其中一些可能通过免疫接种预防。引起百日咳的百日咳杆菌尚未在这方面进行研究。我们的目的是评估博德特氏菌感染在AECB患者中的作用。患者和方法：2000年10月至2002年6月期间，在瑞士巴塞尔参加私人诊所的AECB患者通过标准化问卷、鼻咽拭子培养（博德特氏菌属）、和PCR（博德特氏菌属（Bordetella spp.）结果：共纳入26例患者（34-86岁），均行血清学检查，并与其他呼吸道病原体进行比较。ALL培养和PCR样本均为阴性。血清学检查显示8例（31%）患者存在博德特氏菌感染。与无博德特罗氏菌感染的患者相比，博德特氏菌感染患者的咳嗽持续时间较短（平均15天vs 41天，p = 0.04）。咳嗽持续时间大于或等于21天的7例患者中有3例（43%）存在博德特罗氏菌感染的证据，而18例对照中有17例（94%）（p = 0.012）。从最初到随访4-6周后的恢复期进展是可比的两个groups.Conclusion：波氏杆菌感染似乎在AECB和预防措施，如免疫接种无细胞百日咳疫苗发挥显着的作用，应考虑。为了证实我们的初步调查结果，需要进行更广泛的调查。
Background: Acute exacerbations of chronic bronchitis (AECB) are associated with a variety of viral and bacterial infectious agents, some of which are potentially preventable by immunization. Bordetella pertussis, which causes whooping cough, has not been studied in this context. We aimed to assess the role of Bordetella infections in patients with AECB.Patients and Methods: Patients with AECB, who presented to participating private practices in Basel, Switzerland, between October 2000 and June 2002, were evaluated by a standardized questionnaire, nasopharyngeal swabs for culture (Bordetella spp.), and PCR (Bordetella spp. and selected other respiratory pathogens) and paired blood samples for serologic diagnosis of Bordetella infection.Results: A total of 26 patients (34-86 years of age) were recruited. ALL culture and PCR samples were negative. Serology revealed Bordetella infection in eight (31%) patients. Duration of cough was shorter in patients with Bordetella infection compared to those without Bordetello infection (mean 15 days vs 41 days, p = 0.04). Cough greater than or equal to 21 days duration was present in three (43%) of seven patients with evidence of Bordetello infection compared to 17 (94%) of 18 controls (p = 0.012). Progression to convalescence from initial to follow-up visit after 4-6 weeks was comparable between both groups.Conclusion: Bordetella infections appear to play a significant rote in AECB and preventive measurements such as immunization with acellular pertussis vaccines should be considered. Extended investigations are necessary to confirm our preliminary and provocative findings.