RT Journal Article
SR Electronic
T1 Pseudomonas infection risk in bronchiectasis: A retrospective cohort analysis of longitudinal microbiology in 174 patients
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2559
VO 40
IS Suppl 56
A1 Hannah Jary
A1 Jim MacFarlane
A1 Katy Hester
A1 Paul McAlinden
A1 Therese Small
A1 John Perry
A1 Kathy Walton
A1 Anthony De Soyza
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/P2559.abstract
AB Background: Pseudomonas aeruginosa (PA) is a key pathogen in bronchiectasis, a disease characterised by recurrent infections. However, little is known of the infection risk in bronchiectasis stratified by levels of airflow impairment.Aims: To explore the relationship between longitudinal airway microbiology in bronchiectasis and clinical markers of disease severity.Methods: A retrospective database review of consecutive adult patients attending a UK bronchiectasis clinic from 2007 and 2010. We stratified patients by lung function (FEV1 % predicted: severe ≤40%; moderate 41-79%; mild ≥ 80%).Results: 174 patients were identified with mean microbiological data for 6 years. Mean exacerbation frequency in 152 patients was 4.17/year; 70% reported 3+ exacerbations per year. Patients had a mean FEV1 % predicted of 65.7 (±30.1), with minimal, moderate and severe airflow limitation found in 27.0%, 50.0% 21.8% of patients respectively (2 patients had missing data). Aetiology of bronchiectasis was found to be idiopathic or post-infectious in 58.8% and COPD in 9.2%. Isolation of Haemophilus influenzae (HI) was more common than of PA (52.9% vs 47.1%), but persistent colonisation was more common with PA. Of patients with minimal airflow limitation, 31.9% isolated PA compared to 71.1% of those with severe airflow limitation. Hospital admissions but not self reported exacerbations were more common in the PA infected group.Conclusions: PA is associated with greater persistence rates and more hospital admissions than HI. PA infection occurs across all strata of lung function impairment. Careful microbiology follow up is required even in those with preserved lung function.