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dc.contributor.authorFrancis, Nick A.
dc.contributor.authorGillespie, David
dc.contributor.authorWootton, M.
dc.contributor.authorWhite, Patrick
dc.contributor.authorBates, Janine
dc.contributor.authorRichards, J.
dc.contributor.authorMelbye, Hasse
dc.contributor.authorHood, Kerenza
dc.contributor.authorButler, Christopher C.
dc.date.accessioned2022-10-04T07:17:35Z
dc.date.available2022-10-04T07:17:35Z
dc.date.issued2020-12-01
dc.description.abstractIntroduction: Identifying predictors of bacterial and viral pathogens in sputum from patients with acute exacerbations of chronic obstructive pulmonary disease (COPD) may help direct management.<p> <p>Methods: We used data from a trial evaluating a C-reactive protein (CRP) point of care guided approach to managing COPD exacerbations in primary care. We used regression analyses to identify baseline clinical features, including CRP value in those randomized to testing, associated with bacterial, viral or mixed infections, defined by the presence of bacterial and viral pathogens in sputum, detected by culture or polymerase chain reaction (PCR), respectively. <p>Results: Of 386 participants with baseline sputum samples, 79 (20.5%), 123 (31.9%), and 91 (23.6%) had bacterial, viral/atypical, and mixed bacterial/viral/atypical pathogens identified, respectively. Increasing sputum purulence assessed by color chart was associated with increased odds of finding bacterial and mixed (bacterial and viral/atypical) pathogens in sputum (area under the ROC curve (AUROC) for bacterial pathogens =0.739 (95% CI: 0.670, 0.808)). Elevated CRP was associated with increased odds of finding bacterial pathogens and mixed pathogens but did not significantly increase the AUROC for predicting bacterial pathogens over sputum color alone (AUROC for combination of sputum color and CRP = 0.776 (95% CI: 0.708, 0.843), p for comparison of models = 0.053). We found no association between the presence of sputum pathogens and other clinical or demographic features. <p>Conclusion: Sputum purulence was the best predictor of sputum bacterial pathogens and mixed bacterial viral/atypical pathogens in patients with COPD exacerbations in our study. Elevated CRP was associated with bacterial pathogens but did not add to the predictive value of sputum purulence.en_US
dc.identifier.citationFrancis NA, Gillespie D, Wootton M, White P, Bates J, Richards J, Melbye H, Hood K, Butler CC. Clinical Features and C-Reactive Protein as Predictors of Bacterial Exacerbations of COPD. International Journal of Chronic Obstructive Pulmonary Disease. 2020;15:3147-3158en_US
dc.identifier.cristinIDFRIDAID 1892503
dc.identifier.doihttps://doi.org/10.2147/COPD.S265674
dc.identifier.issn1614-5291
dc.identifier.urihttps://hdl.handle.net/10037/26965
dc.language.isoengen_US
dc.publisherDovepressen_US
dc.relation.journalInternational Journal of Diachronic Linguistics and Linguistic Reconstruction
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2020 The Author(s)en_US
dc.titleClinical Features and C-Reactive Protein as Predictors of Bacterial Exacerbations of COPD.en_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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