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A national strategy for research in chronic obstructive pulmonary disease.

To the Editor. —In the workshop summary on a proposed national strategy for research in chronic obstructive pulmonary disease (COPD), Drs Petty and Weinmann 1 recommend several important areas of research to pursue. Virtually absent from consideration in the workshop was the role of bacterial infection in the course and the pathogenesis of COPD. Lower respiratory tract infection in patients with COPD is responsible for enormous morbidity, mortality, and health care costs. Chronic obstructive pulmonary disease causes 165 000 deaths, 10 million office visits, and 2 million hospitalizations annually in the United States, 2 with a large proportion of these owing to exacerbations related to infection. 3 Infection was the single most common identifiable cause of death in 1 prospective study of patients with COPD. 4 Preventing such infections would reduce morbidity, improve quality of life, and reduce health care costs. Research into new ways to prevent infection in patients