Erasmus Medical Center, Rotterdam, The Netherlands.
Eur J Clin Microbiol Infect Dis. 2019 Dec;38(12):2299-2304. doi: 10.1007/s10096-019-03675-z. Epub 2019 Aug 31.
About 25% of the patients with bronchiectasis are likely to develop a chronic colonization with Pseudomonas aeruginosa. A better understanding of predictors of acquiring Pseudomonas within the patient population may facilitate future focused research. The aim of this retrospective observational study was to investigate predicting factors for P. aeruginosa colonization in patients with bronchiectasis. This was a single-center retrospective cohort study using a bronchiectasis database which consisted of 211 patients with bronchiectasis. Data were collected for demographic details, etiology, spirometry, microbiology data, maintenance medication use, exacerbation frequency, hospital admission rate, and FACED and Bronchiectasis Severity Index (BSI) score. Two hundred eleven patients were identified from our bronchiectasis database. Overall, 25% of the patients (n = 53) had a chronic colonization with P. aeruginosa. Seventeen patients (8%) died in a 5-year follow-up period of whom 7 (41%) had a chronic P. aeruginosa colonization (p > 0.05). After multiple regression analysis, P. aeruginosa-positive patients were significantly associated with an older age (> 55 years) (p = 0.004), the use of hypertonic saline (0.042), and inhalation antibiotics (< 0.001). Furthermore, the presence of PCD (p < 0.001) and post-infectious etiology (p < 0.001) as underlying causes were significantly associated with P. aeruginosa colonization. We observed that independent predictors for P. aeruginosa colonization were age > 55 years, hypertonic saline, and PCD, and post-infectious etiology as underlying causes of bronchiectasis. Since prevention of P. aeruginosa colonization is an important aim in the treatment of bronchiectasis, more attention could be directed to these groups at risk for Pseudomonas colonization.
约 25%的支气管扩张症患者可能会出现铜绿假单胞菌的慢性定植。更好地了解患者人群中获得铜绿假单胞菌的预测因素,可能有助于未来的针对性研究。本回顾性观察性研究旨在调查支气管扩张症患者铜绿假单胞菌定植的预测因素。这是一项使用支气管扩张症数据库的单中心回顾性队列研究,该数据库包含 211 例支气管扩张症患者。收集人口统计学细节、病因、肺量测定、微生物学数据、维持性药物使用、加重频率、住院率以及 FACED 和支气管扩张严重指数(BSI)评分的数据。从我们的支气管扩张症数据库中确定了 211 例患者。总体而言,25%的患者(n=53)存在铜绿假单胞菌慢性定植。在 5 年的随访期间,有 17 例患者(8%)死亡,其中 7 例(41%)存在慢性铜绿假单胞菌定植(p>0.05)。经过多变量回归分析,铜绿假单胞菌阳性患者与年龄较大(>55 岁)(p=0.004)、使用高渗盐水(0.042)和吸入性抗生素(<0.001)显著相关。此外,存在原发性纤毛运动障碍(PCD)(p<0.001)和感染后病因(p<0.001)作为潜在病因与铜绿假单胞菌定植显著相关。我们观察到,铜绿假单胞菌定植的独立预测因素是年龄>55 岁、高渗盐水和 PCD,以及感染后病因是支气管扩张症的潜在病因。由于预防铜绿假单胞菌定植是支气管扩张症治疗的一个重要目标,因此应该更加关注这些有铜绿假单胞菌定植风险的群体。