POINT: Is Chronic Bacterial Infection Clinically Relevant in COPD? Yes

COPD is a complex and heterogeneous disease characterized by chronic airway inflammation.1 The latter may alter airway antimicrobial defense systems and therefore favor the colonization of the bronchial mucosa by potentially pathogenic microorganisms (PPM).2 The most frequent PPMs that are capable of provoking clinical symptoms or that have impact in the COPD prognosis are listed here: Haemophilus influenza and parainfluenza, Streptococcus pneumoniae, Moraxella Catarrhalis, Pseudomonas aeruginosa, Staphylococcus aureus and some enterobacteriaceae. These PPMs, and more importantly, the presence of chronic bronchial infection (CBI), which is defined as the repeated isolation of PPMs from the airway overtime, could be a potential mechanism of disease progression and poor health outcomes in patients with COPD.3