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Bacterial infections in acute exacerbation of chronic obstructive pulmonary disease: a systematic review and meta-analysis

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Abstract

Objective

Due to the importance of Chronic obstructive pulmonary disease (COPD) as the fourth cause of mortality worldwide and the lack of studies evaluating the prevalence of bacterial infections in disease exacerbation, this systematic review and meta-analysis was performed to determine the prevalence rate of bacterial infections in COPD patients.

Methods

PubMed, ISI Web of Science, and Scopus databases were systematically searched for population-based prevalence studies (1980–2018). MeSH terms for “Bacterial infections” and “AECOPD” were used as search keywords. The selected studies were filtered according to the inclusion and exclusion criteria. Fixed and random-effects models were used for estimation of summary effect sizes. Between-study heterogeneity, as well as publication bias, were calculated.

Results

Finally, 118 out of 31,440 studies were selected. The overall estimation of the prevalence of bacterial infection was 49.59% [95% confidence interval (CI) 0.4418–0.55]. The heterogeneity in estimating the pooled prevalence of bacterial infections was shown in the studies (Cochran Q test: 6615, P < 0.0001, I2 = 98.23%). In addition, S. pneumoniae, H. influenzae, M. catarrhalis, A. baumannii, P. aeruginosa, and S. aureus were the most prevalent reported bacteria.

Conclusions

Our results as the first meta-analysis for the issue demonstrated that bacterial infections are an important risk factor for AECOPD. Further studies must be performed for understanding the exact role of bacterial agents in AECOPD and help physicians for more applicable preventive and therapeutic measurements.

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Authors and Affiliations

  1. Department of Microbiology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran

    Mohsen Moghoofei

  2. Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran

    Sadegh Azimzadeh Jamalkandi & Jafar Salimian

  3. Molecular Biology Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran

    Masood Moein & Ali Ahmadi

Authors
  1. Mohsen Moghoofei
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  2. Sadegh Azimzadeh Jamalkandi
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  3. Masood Moein
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  4. Jafar Salimian
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  5. Ali Ahmadi
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Contributions

Study design: SAJ and AA. Acquisition of data: MM, MM, and JS. Analysis and interpretation of data: MM. Drafting of the manuscript: MM and AA. Critical revision of the manuscript for important intellectual content: SAJ, JS, and MM.

Corresponding author

Correspondence to Ali Ahmadi.

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Conflict of interest

The authors declare that they have no conflicts of interest with the contents of this article.

Ethical approval

This study does not need ethical approval and patient consent. All analyses were according to previously published studies.

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Moghoofei, M., Azimzadeh Jamalkandi, S., Moein, M. et al. Bacterial infections in acute exacerbation of chronic obstructive pulmonary disease: a systematic review and meta-analysis. Infection 48, 19–35 (2020). https://doi.org/10.1007/s15010-019-01350-1

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  • DOI: https://doi.org/10.1007/s15010-019-01350-1

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