Division of Pulmonary, Critical Care and Sleep Medicine, University of Connecticut School of Medicine, USA.
University of Kentucky College of Public Health, USA.
Respir Med. 2022 Mar;193:106746. doi: 10.1016/j.rmed.2022.106746. Epub 2022 Jan 24.
Little information is available about Stenotrophomonas maltophilia in patients with bronchiectasis. We analyzed data from the US Bronchiectasis and NTM Research Registry to determine its prevalence and association with patient characteristics and severity of disease.
Baseline and follow-up data were entered into a central web-based database. Patients were grouped into four cohorts based on their baseline cultures: 1) S. maltophilia, no Pseudomonas aeruginsosa, 2) P. aeruginosa, no S. maltophilia, 3) No pathogens, 4) Pathogens other than P. aeruginosa and S. maltophilia. The association between S. maltophilia, demographic characteristics, pulmonary function, exacerbations and hospitalizations was assessed at baseline and one year follow-up.
Among 2659 patients, 134 (5.0%) had grown S. maltophilia at baseline. The prior exacerbation rate at baseline was similar in patients with S. maltophilia and P. aeruginosa, but significantly higher than the other two groups. Hospitalizations were more frequent in patients with S. maltophilia or P. aeruginosa. Pre-bronchodilator FEV1 among S. maltophilia patients was between that of Pseudomonas patients and patients without either organism, but was not significantly different from any of the other groups. For all risk-adjusted one-year outcomes, patients with S. maltophilia had a non-significant trend towards worse outcomes compared to patients without P. aeruginosa, but were more similar to patients with P aeruginosa.
Bronchiectasis patients with S. maltophilia may have worse outcomes than patients without this organism or without P. aeruginosa; further study is needed to determine if the non-significant trends we note are clinically significant.
有关嗜麦芽窄食单胞菌在支气管扩张症患者中的信息较少。我们分析了美国支气管扩张症和非结核分枝杆菌研究登记处的数据，以确定其流行率及其与患者特征和疾病严重程度的关系。
将基线和随访数据输入到中央网络数据库中。根据基线培养结果，将患者分为四组：1）嗜麦芽窄食单胞菌，无铜绿假单胞菌，2）铜绿假单胞菌，无嗜麦芽窄食单胞菌，3）无病原体，4）除铜绿假单胞菌和嗜麦芽窄食单胞菌以外的病原体。在基线和一年随访时评估嗜麦芽窄食单胞菌与人口统计学特征、肺功能、加重和住院之间的关系。
在 2659 例患者中，134 例（5.0%）基线时培养出嗜麦芽窄食单胞菌。嗜麦芽窄食单胞菌患者和铜绿假单胞菌患者的基线前加重率相似，但显著高于其他两组。嗜麦芽窄食单胞菌或铜绿假单胞菌患者的住院频率更高。嗜麦芽窄食单胞菌患者的支气管舒张剂前 FEV1 处于铜绿假单胞菌患者和无这两种病原体患者之间，但与任何其他组均无显著差异。对于所有风险调整的一年期结局，嗜麦芽窄食单胞菌患者的结局较无铜绿假单胞菌患者无显著改善趋势，但与铜绿假单胞菌患者更相似。
嗜麦芽窄食单胞菌支气管扩张症患者的结局可能比无该病原体或无铜绿假单胞菌患者更差；需要进一步研究以确定我们观察到的非显著趋势是否具有临床意义。
