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Am J Respir Crit Care Med. 2005 Jul 15;172(2):195-9. Epub 2005 Apr 1.

Moraxella catarrhalis in chronic obstructive pulmonary disease: burden of disease and immune response.

Author information

1
Buffalo Veterans Affairs Medical Center (151), 3495 Bailey Avenue, Buffalo, NY 14215, USA. murphyt@buffalo.edu

Abstract

RATIONALE:

Moraxella catarrhalis is frequently present in the sputum of adults with chronic obstructive pulmonary disease (COPD). Little is known about the role of M. catarrhalis in this common disease.

OBJECTIVE:

To elucidate the burden of disease, the dynamics of carriage, and immune responses to M. catarrhalis in COPD.

METHODS:

Prospective cohort study of 104 adults with COPD in an outpatient clinic at the Buffalo Veterans Affairs Medical Center.

MEASUREMENTS:

Clinical information, sputum cultures, molecular typing of isolates, and immunoassays to measure antibodies to M. catarrhalis.

MAIN RESULTS:

Over 81 months, 104 patients made 3,009 clinic visits, 560 during exacerbations. Molecular typing identified 120 episodes of acquisition and clearance of M. catarrhalis in 50 patients; 57 (47.5%) of the acquisitions were associated with clinical exacerbations. No instances of simultaneous acquisition of a new strain of another pathogen were observed. The duration of carriage of M. catarrhalis was shorter with exacerbations compared with asymptomatic colonization (median, 31.0 vs. 40.4 days; p = 0.01). Reacquisition of the same strain was rare. The intensity of the serum IgG response was greater after exacerbations than asymptomatic colonization (p = 0.009). Asymptomatic colonization was associated with a greater frequency of a sputum IgA response than exacerbation (p = 0.009).

CONCLUSIONS:

M. catarrhalis likely causes approximately 10% of exacerbations of COPD, accounting for approximately 2 to 4 million episodes annually. The organism is cleared efficiently after a short duration of carriage. Patients develop strain-specific protection after clearance of M. catarrhalis from the respiratory tract.

PMID:
15805178
PMCID:
PMC2718466
DOI:
10.1164/rccm.200412-1747OC
[Indexed for MEDLINE]
Free PMC Article

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