Pathogenic bacteria and viruses in induced sputum or pharyngeal secretions of adults with stable asthma
- T H Harju1,
- M Leinonen2,
- J Nokso-Koivisto2,
- T Korhonen2,
- R Räty2,
- Q He2,
- T Hovi2,
- J Mertsola3,
- A Bloigu2,
- P Rytilä4,
- P Saikku2,5
- 1Department of Internal Medicine, University of Oulu, Oulu, Finland
- 2National Public Health Institute, Oulu, Turku and Helsinki, Finland
- 3Department of Pediatrics, Turku University Hospital, Turku, Finland
- 4Department of Allergy, Skin and Allergy Hospital, Helsinki University Central Hospital, Helsinki, Finland
- 5Department of Medical Microbiology, University of Oulu, Oulu, Finland
- Correspondence to:
Dr T H Harju
Department of Internal Medicine, P O Box 5000, 90014 University of Oulu, Finland;
- Received 25 November 2005
- Accepted 28 February 2006
- Published Online First 3 March 2006
Background: Respiratory infections are well known triggers of asthma exacerbations, but their role in stable adult asthma remains unclear.
Methods: 103 asthmatics and 30 control subjects were enrolled in the study. Sputum was induced by inhalation of 3% NaCl solution. Oropharyngeal swab specimens were obtained from the posterior wall of the oropharynx. Respiratory specimens were analysed by RT-PCR for rhinovirus, enterovirus and respiratory syncytial virus and by PCR for adenovirus, Chlamydia pneumoniae, Mycoplasma pneumoniae and Bordetella pertussis.
Results: Sputum samples from two of the 30 healthy controls (6.7%), five of 53 patients with mild asthma (9.4%), and eight of 50 with moderate asthma (16.0%) were positive for rhinovirus. Rhinovirus positive asthmatic subjects had more asthma symptoms and lower forced expiratory volume in 1 second (FEV1) (79% predicted) than rhinovirus negative cases (93.5% predicted; p = 0.020). Chlamydia pneumoniae PCR was positive in 11 healthy controls (36.6%), 11 mild asthmatics (20.8%), and 11 moderate asthmatics (22%), and PCR positive asthmatics had lower FEV1/FVC than negative cases (78.2% v 80.8%, p = 0.023). Bordetella pertussis PCR was positive in 30 cases: five healthy controls (16.7%), 15 mild asthmatics (28.3%), and 10 moderate asthmatics (20%). Bordetella pertussis positive individuals had lower FEV1/FVC (77.1% v 80.7%, p = 0.012) and more asthma symptoms than B pertussis negative cases.
Conclusions: Rhinovirus, C pneumoniae, and B pertussis are found in the sputum or pharyngeal swab specimens of asthmatic subjects without concurrent symptoms of infection or asthma exacerbation, as well as in some healthy controls. Positivity is associated with lower lung function and more frequent asthma symptoms.
- CRP, C-reactive protein
- FEV1, forced expiratory volume in 1 second
- FVC, forced vital capacity
- PCR, polymerase chain reaction
- RSV, respiratory syncytial virus
Published Online First 3 March 2006
This work was supported by a grant from the Finnish Anti-Tuberculosis Association Foundation, the Finnish Lung Health Association, and the University of Oulu Scholarship Foundation.
Competing interests: none declared.