sj-docx-1-tar-10.1177_17534666231169472 – Supplemental material for Heterogeneity of asthma–chronic obstructive pulmonary disease (COPD) overlap from a cohort of patients with severe asthma and COPD

Supplemental material, sj-docx-1-tar-10.1177_17534666231169472 for Heterogeneity of asthma–chronic obstructive pulmonary disease (COPD) overlap from a cohort of patients with severe asthma and COPD by Joon Young Choi, Chin Kook Rhee, Kwang Ha Yoo, Ki-Suck Jung, Jae Ha Lee, Hyoung Kyu Yoon, Seung Won Ra, Myung Goo Lee and Yong Suk Jo in Therapeutic Advances in Respiratory Disease</p

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

<div><p>Background</p><p>Although acute bronchitis is quite common, there is relatively limited information regarding the microorganisms that are involved in this illness.</p><p>Methods</p><p>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.</p><p>Results</p><p>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 <i>Haemophilus influenzae</i> (n = 39) and <i>Streptococcus pneumoniae</i> (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 (<i>p</i> = 0.029), and typical bacterial infections showed a trend towards a higher prevalence with older age (<i>p</i> = 0.001).</p><p>Conclusions</p><p>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.</p></div

Seasonal distribution of the causative viruses identified in 291 patients with acute bronchitis.

<p>Seasonal distribution of the causative viruses identified in 291 patients with acute bronchitis.</p

Distribution of the microorganisms identified in 291 patients with acute bronchitis according to lung co-morbidities.

<p>Distribution of the microorganisms identified in 291 patients with acute bronchitis according to lung co-morbidities.</p

Clinical characteristics of 811 patients with acute bronchitis.

<p>Clinical characteristics of 811 patients with acute bronchitis.</p

Characteristics of patients with acute bronchitis according to microbiological categories in 291 patients with acceptable sputum (Murray-Washington classification degree IV or V).

<p>Characteristics of patients with acute bronchitis according to microbiological categories in 291 patients with acceptable sputum (Murray-Washington classification degree IV or V).</p

Etiology of acute bronchitis in 291 patients with acceptable sputum and 520 patients with unacceptable sputum.

<p>Etiology of acute bronchitis in 291 patients with acceptable sputum and 520 patients with unacceptable sputum.</p

Distribution of the microorganisms identified in 291 patients with acute bronchitis with acceptable sputum.

<p>Distribution of the microorganisms identified in 291 patients with acute bronchitis with acceptable sputum.</p

Does repeated pleural culture increase the diagnostic yield of <i>Mycobacterium tuberculosis</i> from tuberculous pleural effusion in HIV-negative individuals?

<div><p>Background</p><p>Despite recent advances in methods for culturing <i>Mycobacterium tuberculosis</i> (MTB), the diagnostic yield of tuberculous pleural effusion (TBPE) remains unsatisfactory. However, unlike repeated sputum cultures of pulmonary tuberculosis, little is known about the role of repeated pleural cultures. We examined whether repeated pleural cultures are associated with increased MTB yield from TBPE.</p><p>Methods</p><p>A multicenter, retrospective cohort study was performed from January 2012 to December 2015 in South Korea. Patients were categorized into two groups: single- or repeated-culture groups. The diagnostic yield of MTB and clinical, radiological, and pleural fluid characteristics were evaluated.</p><p>Results</p><p>Among the 329 patients with TBPE, 77 (23.4%) had repeated cultures and 252 (76.5%) had a single culture. Pleural culture was performed twice in all 77 patients in the repeated-culture group at a 1-day interval (inter-quartile range, 1.0–2.0). In the repeated-culture group, the yield of MTB from the first culture was 31.2%, which was similar to that in the single-culture group (31.2% vs. 29.8%, P = 0.887). However, the yield of MTB from the second culture (10/77, 13.0%) was more than that from the first. These results may be attributable to the insufficient immune clearance for MTB invasion into the pleural space between the first and second cultures. Over time, the yield of the second cultures decreased from 17.4% to 6.7% and then 6.3%. Finally, the overall yield of MTB in the repeated- and single-culture groups was 44.2% and 29.8% respectively (P < 0.001).</p><p>Conclusions</p><p>The results showed that repeated pleural cultures increased MTB yield from TBPE in human immunodeficiency virus-negative individuals. Furthermore, repeated cultures may increase yield when carried out for two consecutive days.</p></div

Biochemical changes in sequential examinations of 77 cases in the repeated pleural culture group.

<p>Biochemical changes in sequential examinations of 77 cases in the repeated pleural culture group.</p