Patients hospitalised with an infective exacerbation of bronchiectasis unrelated to cystic fibrosis: Clinical, physiological and sputum characteristics

Abstract

Introduction: Bronchiectasis is a growing health burden globally. Characterised by cough, retention of tenacious purulent sputum leading to infection and airway scarring, it is associated with repeated respiratory infections (exacerbations) resulting in hospital admissions, impaired quality of life and lung function, and a shortened life expectancy.

Aim: To describe the clinical, physiological and sputum characteristics in patients hospitalised with an infective exacerbation of bronchiectasis.

Method: Medical records of consecutive adult patients admitted to a metropolitan Australian hospital with an exacerbation of bronchiectasis in a calendar year were examined .

Results: 61 patients were identified. Mean(SD) age of participants was 66(14) years; 56% women, 86% non smokers/ ex smokers; Most had coexisting medical conditions, with asthma noted in 50%. 72% were on regular inhalers, 23% on cyclical antibiotics; 26% undertook regular respiratory physiotherapy. Moderate airflow obstruction was noted on lung function tests(FEV₁ 55% predicted). Bronchodilator reversibility was present in 17%. Sputum demonstrated normal flora in 17%, Pseudomonas aeruginosa in 32%, Haemophilus in 15%. Mean exacerbation rate was 2.3 /year. Pseudomonas aeruginosa was associated with more symptoms and poor lung function. Predictors for an exacerbation included lung function and presence of Pseudomonas aeruginosa.

Conclusion: Adult patients hospitalised with an infective exacerbation of bronchiectasis in our series are predominantly female, non smokers with antibiotic responsive Pseudomonas aeruginosa, which is associated with frequent exacerbations.