Evidence map›Paper›PMID 26089657›Full record

ArticleInternational journal of chronic obstructive pulmonary disease2015

Airway bacteria measured by quantitative polymerase chain reaction and culture in patients with stable COPD: relationship with neutrophilic airway inflammation, exacerbation frequency, and lung function.

Mona Bafadhel, Koirobi Haldar, Bethan Barker, Hemu Patel, Vijay Mistry, Michael R Barer, Ian D Pavord, Christopher E Brightling

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of chronic obstructive pulmonary disease, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
52citing papers in PubMed, 3 pooled it
5.0field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

52 citing papers in PubMed, 3 syntheses or guidelines pooled it, 75 citations in OpenAlex.

  1. Pooled it
  2. Procalcitonin to guide antibiotic administration in COPD exacerbations: a meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2017
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  8. Review
  9. Article
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  11. A translational view of airway epithelial dysfunction in COPD.European respiratory review : an official journal of the European Respiratory Society · 2025
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  15. Article
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  18. How inhaled corticosteroids target inflammation in COPD.European respiratory review : an official journal of the European Respiratory Society · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 1 country.

Mona BafadhelRespiratory Medicine Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
Koirobi HaldarDepartment of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK.
Bethan BarkerDepartment of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK ; Institute for Lung Health, National Institute for Health Research Respiratory Biomedical Research Unit, Glenfield Hospital, University of Leicester, Leicester, UK.
Hemu PatelDepartment of Clinical Microbiology, University Hospitals of Leicester NHS Trust, Leicester, UK.
Vijay MistryDepartment of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK ; Institute for Lung Health, National Institute for Health Research Respiratory Biomedical Research Unit, Glenfield Hospital, University of Leicester, Leicester, UK.
Michael R BarerDepartment of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK ; Institute for Lung Health, National Institute for Health Research Respiratory Biomedical Research Unit, Glenfield Hospital, University of Leicester, Leicester, UK ; Department of Clinical Microbiology, University Hospitals of Leicester NHS Trust, Leicester, UK.
Ian D PavordRespiratory Medicine Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
Christopher E BrightlingDepartment of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK ; Institute for Lung Health, National Institute for Health Research Respiratory Biomedical Research Unit, Glenfield Hospital, University of Leicester, Leicester, UK.
National Institute for Health Research · GBUniversity Hospitals of Leicester NHS Trust · GBUniversity of Oxford · GBUniversity of Leicester · GB

Funding

Department of Health PDF-2013-06-052Medical Research Council G0601369Wellcome Trust
6 · The paper itself

Abstract

backgroundPotentially pathogenic microorganisms can be detected by quantitative real-time polymerase chain reaction (qPCR) in sputum from patients with COPD, although how this technique relates to culture and clinical measures of disease is unclear. We used cross-sectional and longitudinal data to test the hypotheses that qPCR is a more sensitive measure of bacterial presence and is associated with neutrophilic airway inflammation and adverse clinical outcomes.

methodsSputum was collected from 174 stable COPD subjects longitudinally over 12 months. Microbial sampling using culture and qPCR was performed. Spirometry and sputum measures of airway inflammation were assessed.

findingsSputum was qPCR-positive (>10(6) copies/mL) in 77/152 samples (Haemophilus influenzae [n=52], Moraxella catarrhalis [n=24], Streptococcus pneumoniae [n=19], and Staphylococcus aureus [n=7]). Sputum was culture-positive in 50/174 samples, with 49 out of 50 culture-positive samples having pathogen-specific qPCR bacterial loads >10(6) copies/mL. Samples that had qPCR copy numbers >10(6)/mL, whether culture-positive or not, had increased sputum neutrophil counts. H. influenzae qPCR copy numbers correlated with sputum neutrophil counts (r=0.37, P<0.001), were repeatable within subjects, and were >10(6)/mL three or more times in 19 patients, eight of whom were repeatedly sputum culture-positive. Persistence, whether defined by culture, qPCR, or both, was associated with a higher sputum neutrophil count, lower forced expiratory volume in 1 second (FEV1), and worsened quality of life.

interpretationqPCR identifies a significant number of patients with potentially bacteria-associated neutrophilic airway inflammation and disease that are not identified by traditional culture-based methods.

Indexed as

Bacteriological TechniquesNeutrophil InfiltrationReal-Time Polymerase Chain ReactionSpirometryAgedBacteriaBacterial LoadCross-Sectional StudiesDisease ProgressionDNA, BacterialFemaleForced Expiratory VolumeHaemophilus influenzaeHumansLongitudinal StudiesLungDNA, BacterialH. influenzaeqPCRsputum

Identifiers

PMID26089657
PMCPMC4468933
OpenAlexW1624745984

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.