Keywords: COPD, community acquired pneumonia, exacerbations, acute events, microbiology, respiratory microbiome

“Respiratory infections, exacerbations and the microbiome in COPD”

Chronic Obstructive Pulmonary Disease (COPD) is featured by acute events such as respiratory infections and exacerbations. So far, much remains unknown about the impact of COPD on community acquired pneumonia (CAP). This dissertation shows that patients with COPD have a 4.5 times higher risk of developing CAP, regardless smoking status. Moreover, patients with COPD had on average more severe CAP, with a different bacterial pathology and higher mortality rates. Recently, respiratory microbiome (i.e. all micro-organisms in the lungs) analysis is positioned as a promising technique to overcome pressing questions concerning the microbiology of the lungs, related to these acute events. Our results show that the respiratory microbiome is diverse, depending on the place of sampling. But different specimens within one patient are more alike than similar specimens of other patients. However, respiratory microbiome analysis is complex and further research is essential.