While the medical profession has long agreed that bacteria in the lungs of chronic obstructive pulmonary disease (COPD) patients are harmless when independent of flare-ups or exacerbations of respiratory symptoms, a new study may suggest otherwise.
The study, “Bacterial Colonization Increases Daily Symptoms in Patients with Chronic Obstructive Pulmonary Disease,” which was published in the January 2014 issue of the Annals of the American Thoracic Society, found that COPD patients do in fact experience more respiratory symptoms when their lungs are colonized by bacteria, even in the absence of an acute exacerbation.
The study examined41 elderly male veterans with smoking-related COPD in the COPD Study Clinic at the Buffalo VA, focusing on four common pathogens encountered in COPD – Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae and Pseudomonas aeruginosa. Researchers used sensitive molecular detection methods, as well as conventional laboratory cultures, to detect these bacterial pathogens, while patients used electronic diaries to record daily symptoms of breathlessness, cough and sputum.
“The lungs are constantly being exposed to microbes ‘with every breath you take’ as well as from aspiration of small amounts of secretions from the throat, especially during sleep,” said senior author Sanjay Sethi, MD, professor of medicine and chief of pulmonary, critical care and sleep medicine and staff physician with the Veterans Affairs Western New York Healthcare System. “If the persistence of these bacteria contributes to increased symptoms and inflammation in the lungs in stable COPD, we should regard this as a chronic infection, not innocuous colonization.”
For that reason, Dr. Sethi believes that more must be cone to reduce chronic infections in COPD patients.
“These findings demonstrate that it’s time for a paradigm shift in how we treat patients with stable COPD,” said Dr. Sethi. “We need to go beyond traditional approaches of bronchodilation and anti-inflammatory agents to reduce symptoms. We need to put more emphasis on developing therapies that can decrease bacterial colonization in COPD.”