Pseudomonas aeruginosaisolation in patients with non-cystic fibrosis bronchiectasis: a retrospective study

Abstract

ObjectivesPseudomonas aeruginosa (P. aeruginosa)occupies an important niche in the pathogenic microbiome of bronchiectasis. The objective of this study is to evaluate the clinical characteristics and prognostic value ofP. aeruginosain Chinese adult patients with bronchiectasis.MethodsThis retrospective and follow-up study enrolled 1188 patients diagnosed with bronchiectasis at Shanghai Pulmonary Hospital between January 2011 and December 2012. The patients’ clinical data including anthropometry, clinical symptoms, serum biomarkers, radiographic manifestations and lung function indices were reviewed. The median follow-up duration (IQR) was 44 (40-54) months, during which 289 patients were lost to follow-up. Data from 899 patients were collected and analysed for the outcomes of mortality, annual exacerbation frequency and health-related quality of life.ResultsP. aeruginosawas isolated from 232 patients, alongside other pathogens such asAspergillus(n=75) andCandida albicans(n=72). There were 74 deaths (12% of patients withP. aeruginosa, 7.3% of those without) over the course of the follow-up. The isolation ofP. aeruginosawas a risk factor for all-cause mortality (HR, 3.07; 95% CI 1.32 to 7.15) and was associated with high rates of exacerbations (ie, ≥3 exacerbations per year of follow-up) (HR, 2.40; 95% CI 1.20 to 4.79). Patients withP. aeruginosaalso had worse scores on the Hospital Anxiety and Depression Scale (anxiety, p=0.005; depression, p<0.001), the Leicester Cough Questionnaire (p=0.033) and the modified Medical Research Council scale (p=0.001) compared with those withoutP. aeruginosa.ConclusionsIsolation ofP. aeruginosain patients with bronchiectasis is a significant prognostic indicator and should be a major factor in the clinical management of the disease.