Microorganisms Causing Community-Acquired Acute Bronchitis: The Role of Bacterial Infection

• Published in: PloS one Vol. 11; no. 10; p. e0165553
• Main Authors: Park, Ji Young, Park, Sunghoon, Lee, Sun Hwa, Lee, Myung Goo, Park, Yong Bum, Oh, Kil Chan, Lee, Jae-Myung, Kim, Do Il, Seo, Ki-Hyun, Shin, Kyeong-Cheol, Yoo, Kwang Ha, Ko, Yongchun, Jang, Seung Hun, Jung, Ki-Suck, Hwang, Yong Il
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 27.10.2016; Public Library of Science (PLoS)
• Subjects: Acute Disease; Adult; Adults; Analysis; Antibiotics; Bacteria; Bacterial infections; Bacterial Infections - microbiology; Biology and Life Sciences; Bronchitis; Bronchitis - microbiology; Chronic obstructive pulmonary disease; Clinics; Communities; Community-Acquired Infections - microbiology; Coronaviridae; Coronaviruses; Critical care; Enterovirus; Epidemiology; Etiology; Haemophilus influenzae; Health aspects; Hospitals; Humans; Infections; Influenza; Internal medicine; Lung diseases; Medicine; Medicine and Health Sciences; Microorganisms; Pathogens; Patients; Picornaviridae; Pneumonia; Polymerase chain reaction; Prospective Studies; Republic of Korea; Rhinovirus; Sputum; Streptococcus infections; Streptococcus pneumoniae; Studies; Viral infections; Viruses; South Korea
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0165553

Although acute bronchitis is quite common, there is relatively limited information regarding the microorganisms that are involved in this illness. We performed a prospective study of acute bronchitis at 31 hospitals and clinics in Korea from July 2011 to June 2012. Sputum specimens were collected for polymerase chain reaction (PCR) and culture of microorganisms. Of the 811 enrolled patients, 291 had acceptable sputum specimens that were included for analysis of the etiologic distribution. With multiplex PCR testing, viruses were identified in 36.1% (105/291), most commonly rhinovirus (25.8%) and coronavirus (3.8%). Typical bacteria were isolated in 126/291 (43.3%) patients. Among these patients Haemophilus influenzae (n = 39) and Streptococcus pneumoniae (n = 30) were isolated most commonly; atypical bacteria were identified in 44 (15.1%) patients. Bacteria-only, virus-only, and mixed infections (bacteria plus virus) accounted for 36.7% (98/291), 17.2% (50/291), and 18.9% (55/291) of infections, respectively. In particular, 52.4% of patients with viral infection had a concurrent bacterial infection, and rhinovirus was the most common virus in mixed infections (40/55). Additionally, infections with typical bacteria were more common in patients with chronic lung disease (p = 0.029), and typical bacterial infections showed a trend towards a higher prevalence with older age (p = 0.001). Bacteria were associated with almost half of community-acquired acute bronchitis cases. Additional studies are required to further illuminate the role of bacteria and to identify patient groups most likely to benefit from antibiotic treatment.