A Multicenter Study to Identify the Respiratory Pathogens Associated with Exacerbation of Chronic Obstructive Pulmonary Disease in Korea

Hyun Woo Lee, Yun Su Sim, Ji Ye Jung, Hyewon Seo, Jeong Woong Park, Kyung Hoon Min, Jae Ha Lee, Byung Keun Kim, Myung Goo Lee, Yeon Mok Oh, Seung Won Ra, Tae Hyung Kim, Yong Il Hwang, Chin Kook Rhee, Hyonsoo Joo, Eung Gu Lee, Jin Hwa Lee, Hye Yun Park, Woo Jin Kim, Soo Jung UmJoon Young Choi, Chang Hoon Lee, Tai Joon An, Yeonhee Park, Young Soon Yoon, Joo Hun Park, Kwang Ha Yoo, Deog Kyeom Kim

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Background: Although respiratory tract infection is one of the most important factors triggering acute exacerbation of chronic obstructive pulmonary disease (AE-COPD), limited data are available to suggest an epidemiologic pattern of microbiology in South Korea. Methods: A multicenter observational study was conducted between January 2015 and December 2018 across 28 hospitals in South Korea. Adult patients with moderate-to-severe acute exacerbations of COPD were eligible to participate in the present study. The participants underwent all conventional tests to identify etiology of microbial pathogenesis. The primary outcome was the percentage of different microbiological pathogens causing AE-COPD. A comparative microbiological analysis of the patients with overlapping asthma–COPD (ACO) and pure COPD was performed. Results: We included 1,186 patients with AE-COPD. Patients with pure COPD constituted 87.9% and those with ACO accounted for 12.1%. Nearly half of the patients used an inhaled corticosteroid-containing regimen and one-fifth used systemic corticosteroids. Respiratory pathogens were found in 55.3% of all such patients. Bacteria and viruses were detected in 33% and 33.2%, respectively. Bacterial and viral coinfections were found in 10.9%. The most frequently detected bacteria werePseudomonas aeruginosa (9.8%), and the most frequently detected virus was influenza A (10.4%). Multiple bacterial infections were more likely to appear in ACO than in pure COPD (8.3% vs. 3.6%, p=0.016). Conclusion: Distinct microbiological patterns were identified in patients with moderate-to-severe AE-COPD in South Korea. These findings may improve evidence-based management of patients with AE-COPD and represent the basis for further studies investigating infectious pathogens in patients with COPD.

Original languageEnglish
Pages (from-to)37-46
Number of pages10
JournalTuberculosis and Respiratory Diseases
Issue number1
StatePublished - Jan 2022

Bibliographical note

Funding Information:
This work was supported by Grant No. KATRD-S-2019-1 awarded by the Korean Academy of Tuberculosis and Respiratory Diseases.

Publisher Copyright:
Copyright © 2022 The Korean Academy of Tuberculosis and Respiratory Diseases.


  • Bacteriology
  • Chronic Obstructive
  • Microbiology
  • Pulmonary Disease
  • Symptom Flare Up
  • Virology


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