Médecine pulmonaire et respiratoire

Bacterial Lung Disease and COPD

Abstract

Sanjay S. Gautam and Ronan F. O’Toole

Pneumonia is the single largest infectious cause of death in children worldwide and a major cause of mortality in the elderly. Tuberculosis (TB) is the leading cause of mortality due to respiratory infection worldwide, killing approximately 1.5 million people each year. It is perhaps not surprising that the bulk of applied research on these high burden diseases has focussed on the development of new vaccines, diagnostic tools, and therapeutic interventions. However, in recent years, it has become apparent that both transmissible diseases contribute to the development of a major non-communicable disease, namely, chronic obstructive pulmonary disease (COPD). The latter chronic illness is emerging as the third largest cause of human mortality worldwide after heart disease and stroke and hence, there is acute interest in understanding its genesis and development. In this review, we examine the evidence that previous lower respiratory tract infectious disease is a contributory factor in the development of COPD. Based on the available data, there is an apparent epidemiological association between pneumonia, TB and COPD in later life. In addition, elements of COPD treatment place patients at a higher risk of presenting with pneumonia or TB. There is now a need to generate a deeper understanding of the interactions between bacterial lung disease and COPD from which new, complementary preventive and co-management strategies can be designed.