Long-Term Risk of Mortality Associated with Isolation of Pseudomonas aeruginosa in COPD: A Systematic Review and Meta-Analysis.

Autor:	Martinez-García MA; Pneumology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain.; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain., Rigau D; Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain., Barrecheguren M; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.; Pneumology Department, Hospital Universitari Vall d´Hebron, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain., García-Ortega A; Pneumology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain., Nuñez A; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.; Pneumology Department, Hospital Universitari Vall d´Hebron, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain., Oscullo Yepez G; Pneumology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain., Miravitlles M; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.; Pneumology Department, Hospital Universitari Vall d´Hebron, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.
Jazyk:	angličtina
Zdroj:	International journal of chronic obstructive pulmonary disease [Int J Chron Obstruct Pulmon Dis] 2022 Feb 16; Vol. 17, pp. 371-382. Date of Electronic Publication: 2022 Feb 16 (Print Publication: 2022).
DOI:	10.2147/COPD.S346294
Abstrakt:	Background: Chronic bronchial infection is frequent in chronic obstructive pulmonary disease (COPD), but the impact of the isolation of pathogenic bacteria, and in particular Pseudomonas aeruginosa (PA) in respiratory samples on the prognosis of COPD is unclear. Methods: We conducted a systematic review of prognostic studies including patients with isolation of PA in sputum in stable state or during exacerbations of COPD. The main outcomes were all-cause mortality, respiratory mortality, and number and severity of future exacerbations. Data were expressed as hazard ratio (HR) (95% confidence interval [CI]) whenever possible. Results: Of 2773 studies, eight were finally included (23,228 individuals). The mean age ranged from 65.5 to 73 years. Six studies reported data for all-cause mortality. The adjusted risk of death was almost double in patients with PA isolation (HR 1.95, 95% CI, 1.34 to 2.84; quality of evidence moderate). Patients with PA isolation showed a three times higher adjusted risk of readmission at 30 days after discharge (OR 3.60, 95% CI, 3.60 to 12.03, 1 study; quality of evidence very low), and more than double adjusted risk of death and hospitalization at two years (HR 2.80, 95% CI, 2.20 to 3.56, 1 study; quality of evidence very low). Conclusion: There is moderate certainty that the isolation of PA in sputum is associated with an adjusted increased risk of death in patients with COPD. Competing Interests: Miguel Angel Martinez-Garcia has received fees from Chiesi, GlaxoSmithKline, Menarini, Rovi, Bial, Zambon, Vitalire, TEVA, Grifols and Novartis, consulting fees from Grifols, Zambon and TEVA, and research grants from TEVA, Zambon and Vitalaire. David Rigau reports grants from Boehringer Ingelheim. Miriam Barrecheguren has received speaker fees from Grifols, Menarini, CSL Behring, GSK, Boehringer Ingelheim and consulting fees from GSK, Novartis and Boehringer Ingelheim. Marc Miravitlles has received speaker fees from AstraZeneca, Atriva Therapeutics, Boehringer Ingelheim, Chiesi, Cipla, GlaxoSmithKline, Menarini, Rovi, Bial, Sandoz, Zambon, CSL Behring, Grifols and Novartis, consulting fees from AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Bial, Gebro Pharma, Kamada, CSL Behring, Laboratorios Esteve, Ferrer, Johnson & Johnson, Mereo Biopharma, Palobiofarma SL, Takeda, Verona Pharma, TEVA, Spin Therapeutics, pH Pharma, ONO Pharma, Novartis, Sanofi and Grifols and research grants from Grifols. The remaining authors have no conflicts of interest to disclosure. (© 2022 Martinez-García et al.)
Databáze:	MEDLINE
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