Pseudomonas aeruginosa in Chronic Obstructive Pulmonary Disease Patients with Frequent Hospitalized Exacerbations: A Prospective Multicentre Study
| Autor: | Guillermo Suarez-Cuartin, Anna Feliu, Ana Rodrigo-Troyano, Valentina Melo, Oriol Sibila, Lidia Perea, Meritxell Peiro, Elena Laserna, Marcos I. Restrepo, Pedro J. Marcos, Vicente Plaza, Antonio Anzueto, Paola Faverio |
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| Rok vydání: | 2018 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty COPD Exacerbation Copd patients business.industry Pseudomonas aeruginosa Pulmonary disease medicine.disease medicine.disease_cause respiratory tract diseases 03 medical and health sciences 0302 clinical medicine 030228 respiratory system Internal medicine medicine 030212 general & internal medicine business |
| Zdroj: | Respiration. 96:417-424 |
| ISSN: | 1423-0356 0025-7931 |
| DOI: | 10.1159/000490190 |
| Popis: | Background: Pseudomonas aeruginosa (PA) is a common microorganism related to severe exacerbations in Chronic Obstructive Pulmonary Disease (COPD). However, their role in COPD patients with frequent hospitalized exacerbations (FHE) is not well described. Objectives: We aimed to determine prevalence, risk factors, susceptibility patterns and impact on outcomes of PA in COPD patients with FHE. Methods: Prospective observational multicentre study that included COPD patients with FHE. The cohort was stratified in 2 groups according to the presence or absence of PA isolation in sputum. Patients were followed up for 12 months. Results: We enrolled 207 COPD patients with FHE. In 119 patients (57%), a valid sputum culture was collected. Of them, PA was isolated in 21 patients (18%). The risk factors associated with PA were prior use of systemic corticosteroids (OR 3.3, 95% CI 1.2–9.7, p = 0.01) and prior isolation of PA (OR 4.36, 95% CI 1.4–13.4, p < 0.01). Patients with PA had an increased risk of having ≥3 readmissions (OR 4.1, 95% CI 1.3–12.8, p = 0.01) and higher PA isolation rate (OR 7.7, 95% CI 2.4–24.6, p < 0.001) during the follow-up period. In 14 patients (67%), PA was resistant to at least one antibiotic tested. PA persisted in the sputum in 70% of patients. Conclusions: The presence of PA was related to 3 or more readmissions during the 1-year follow-up and PA persisted in the sputum despite an appropriate antibiotic treatment. This finding suggested an important role of PA in the course of the disease of COPD patients with FHE. |
| Databáze: | OpenAIRE |
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