Infectious exacerbations of chronic obstructive pulmonary disease associated with respiratory viruses and non-typeable Haemophilus influenzae

FEMS Immunol Med Microbiol. 2003 Jun 10;37(1):69-75. doi: 10.1016/S0928-8244(03)00100-7.


Infectious exacerbations of chronic obstructive pulmonary disease (COPD) have been reported to occur with both viral and bacterial pathogens. In this study, 35 exacerbations associated with the isolation of non-typeable Haemophilus influenzae from sputum were identified as part of a prospective longitudinal study. Samples from these patients were subjected to immunoassays to identify a new immune response to the homologous isolate of non-typeable H. influenzae to more accurately assess a bacterial etiology. These patients also were studied carefully for evidence of viral infection using viral culture, serology and polymerase chain reaction-based assays. Sixteen of 35 exacerbations (45.7%) were associated with evidence of acute viral infection and 11 of the 35 exacerbations (31.4%) were associated with the development of new serum IgG to homologous non-typeable H. influenzae. Overall, evidence of infection with a respiratory virus or non-typeable H. influenzae was seen in 24 of 35 exacerbations (68.6%). No association between viral infection and immune response to non-typeable H. influenzae was observed, although a trend toward an immune response to non-typeable H. influenzae and absence of viral infection was seen. The results show that exacerbations in adults with COPD were associated with infection caused by virus alone, non-typeable H. influenzae alone, or virus and non-typeable H. influenzae simultaneously.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Antibodies, Bacterial / blood*
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Haemophilus Infections / immunology
  • Haemophilus Infections / microbiology
  • Haemophilus influenzae / classification
  • Haemophilus influenzae / genetics
  • Haemophilus influenzae / isolation & purification*
  • Humans
  • Immunoglobulin G / blood
  • Male
  • Middle Aged
  • Pulmonary Disease, Chronic Obstructive / complications*
  • Respiratory Tract Infections / microbiology*
  • Respiratory Tract Infections / virology*
  • Sputum / microbiology
  • Sputum / virology
  • Virus Diseases / virology*
  • Viruses / classification
  • Viruses / isolation & purification


  • Antibodies, Bacterial
  • Immunoglobulin G