J Korean Med Sci.  2021 Aug;36(34):e217. 10.3346/jkms.2021.36.e217.

Respiratory Viruses in Acute Exacerbations of Bronchiectasis

• Park YE
• Sung H
• Oh YM

• KMID: 2519594
• DOI: http://doi.org/10.3346/jkms.2021.36.e217

Abstract

Background
Bacterial infections are well known factors underlying acute exacerbations in bronchiectasis. However, viral infections may also contribute to acute exacerbations. We aimed to assess the rate of viral detection in acute exacerbations of bronchiectasis, and the associated clinical factors.
Methods
Diagnostic tests for viral and bacterial etiologies were performed in 792 patients with bronchiectasis who visited the emergency room or the respiratory care inpatient unit in a tertiary referral center in South Korea. All patients were diagnosed with bronchiectasis by chest computerized tomography and were prescribed antibiotics for a minimum of 3 days.
Results
Viral pathogens were detected in 202 of the 792 enrolled patients (25.5%). The most common viral pathogen isolated was influenza A virus (24.8%), followed by rhinovirus (22.4%), influenza B virus (9.8%), respiratory syncytial virus B (8.9%), and human metapneumovirus (6.1%). In 145 patients, a viral, but not bacterial, pathogen was detected, whereas no pathogens were found in 443 patients with exacerbations. Multivariable analysis revealed that female sex and chronic heart disease as a comorbidity were positively associated with viral detection in acute exacerbations of patients with bronchiectasis, whereas the presence of radiographic infiltration was negatively associated.
Conclusion
Respiratory viruses were identified in approximately 25% of the acute exacerbations observed among patients with bronchiectasis. Of the viruses detected, influenza viruses and rhinovirus made up over 50%. More attention to viruses as possible causative pathogens for acute deteriorating symptoms in patients with bronchiectasis is warranted.

Keyword

Bronchiectasis; Acute Exacerbation; Respiratory Viruses

Figure

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  Fig. 1 Flow of patient selection. Index visit refers to the first medical visit for exacerbation during the study period.CT = computerized tomography, ER = emergency room.

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  Fig. 2 Seasonal distribution of viral pathogens detected in patients with acute exacerbation of bronchiectasis. Adenovirus, bocavirus, and enterovirus were excluded because the number of cases detected was less than 10.

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