The Role of Bordetella Infections in Patients with Acute Exacerbation of Chronic Bronchitis

Abstract

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 Bordetella infection (mean 15 days vs 41 days, p = 0.04). Cough ≥ 21 days duration was present in three (43%) of seven patients with evidence of Bordetella 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 role 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.

Comparison Study of Oropharyngeal Microbiota in Case of Bronchial Asthma and Chronic Obstructive Pulmonary Disease in Different Severity Levels

“…Представители этого рода -патогены, вызывающие коклюш и инфекционный бронхит. От-мечается их роль в развитии обострений хронического бронхита [32].…”

The unmet need for pertussis prevention in patients with chronic obstructive pulmonary disease in the Italian context

“…While the association between COPD and pertussis in clinical settings has not been investigated extensively, some preliminary studies have shown, albeit in a non-definitive manner, an increase in the risk of pertussis in patients with COPD as compared to non-COPD patients. 32,33 In their pilot study, Bonhoeffer et al 32 assessed patients with acute exacerbations of chronic bronchitis (AECB) (N = 26) for a concomitant presence of Bordetella infection using nasopharyngeal swabs for culture, polymerase chain reaction, and blood samples for serology. The investigators discovered that eight of the patients (31%) were seropositive for Bordetella infections, five of them (19%) being confirmed by ELISA technique to be due to B. pertussis.…”

Management of patients during and after exacerbations of chronic obstructive pulmonary disease: the role of primary care physicians

“…20 Elevated levels of the latter pathogen are more likely to be associated with severe COPD or when systemic steroids and/ or antibiotics had been prescribed in the preceding months 21. In addition, Bordetella pertussis , the re-emergent pathogen responsible for pertussis (whooping cough), has been associated with 31% of acute exacerbations of chronic bronchitis, according to one pilot study 22. While infections are the most common cause of exacerbations,1 the apparent increased susceptibility to this etiologic factor in patients with COPD is not well understood.…”