Epidemiology and Population Studies Unit, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health , Bethesda, USA.
University of Dundee, Ninewells Hospital and Medical School, Dundee, Scotland.
BMC Pulm Med. 2024 Apr 10;24(1):172. doi: 10.1186/s12890-024-02973-3.
Bronchiectasis is a pulmonary disease characterized by irreversible dilation of the bronchi and recurring respiratory infections. Few studies have described the microbiology and prevalence of infections in large patient populations outside of specialized tertiary care centers.
We used the Cerner HealthFacts Electronic Health Record database to characterize the nature, burden, and frequency of pulmonary infections among persons with bronchiectasis. Chronic infections were defined based on organism-specific guidelines.
We identified 7,749 patients who met our incident bronchiectasis case definition. In this study population, the organisms with the highest rates of isolate prevalence were Pseudomonas aeruginosa with 937 (12%) individuals, Staphylococcus aureus with 502 (6%), Mycobacterium avium complex (MAC) with 336 (4%), and Aspergillus sp. with 288 (4%). Among persons with at least one isolate of each respective pathogen, 219 (23%) met criteria for chronic P. aeruginosa colonization, 74 (15%) met criteria for S. aureus chronic colonization, 101 (30%) met criteria for MAC chronic infection, and 50 (17%) met criteria for Aspergillus sp. chronic infection. Of 5,795 persons with at least two years of observation, 1,860 (32%) had a bronchiectasis exacerbation and 3,462 (60%) were hospitalized within two years of bronchiectasis diagnoses. Among patients with chronic respiratory infections, the two-year occurrence of exacerbations was 53% and for hospitalizations was 82%.
Patients with bronchiectasis experiencing chronic respiratory infections have high rates of hospitalization.
支气管扩张症是一种肺部疾病，其特征为支气管不可逆性扩张和反复发生的呼吸道感染。很少有研究描述过在专门的三级护理中心之外的大型患者群体中，感染的微生物学和流行情况。
我们使用 Cerner HealthFacts 电子健康记录数据库来描述支气管扩张症患者肺部感染的性质、负担和频率。慢性感染是根据特定的病原体指南定义的。
我们确定了 7749 名符合我们的支气管扩张症病例定义的患者。在该研究人群中，分离株患病率最高的病原体为铜绿假单胞菌，有 937 人（12%），金黄色葡萄球菌 502 人（6%），鸟分枝杆菌复合群（MAC）336 人（4%），和曲霉菌属 288 人（4%）。在至少有一种相应病原体分离株的人群中，219 人（23%）符合慢性铜绿假单胞菌定植的标准，74 人（15%）符合金黄色葡萄球菌慢性定植的标准，101 人（30%）符合 MAC 慢性感染的标准，50 人（17%）符合曲霉菌属慢性感染的标准。在 5795 名至少有两年观察期的患者中，1860 人（32%）有支气管扩张症恶化，3462 人（60%）在支气管扩张症诊断后的两年内住院。在患有慢性呼吸道感染的患者中，两年内恶化的发生率为 53%，住院的发生率为 82%。
患有慢性呼吸道感染的支气管扩张症患者住院率较高。
