The independent contribution of Pseudomonas aeruginosa infection to long-term clinical outcomes in bronchiectasis

被引：185

作者：

Araujo, David ^{[1
]}

Shteinberg, Michal ^{[2
,3
]}

Aliberti, Stefano ^{[4
,5
,6
]}

Goeminne, Pieter C. ^{[7
,8
]}

Hill, Adam T. ^{[9
,10
]}

Fardon, Thomas C. ^{[11
]}

Obradovic, Dusanka ^{[12
,13
]}

Stone, Glenda ^{[14
]}

Trautmann, Marion ^{[14
]}

Davis, Angela ^{[14
]}

Dimakou, Katerina ^{[15
]}

Polverino, Eva ^{[16
]}

De Soyza, Anthony ^{[17
,18
,19
]}

McDonnell, Melissa J. ^{[19
,20
]}

Chalmers, James D. ^{[11
]}

机构：

[1] Sao Joao Hosp Ctr, Pulmonol Dept, Oporto, Portugal

[2] Carmel Hosp, Pulm Inst, Haifa, Israel

[3] Carmel Hosp, CF Ctr, Haifa, Israel

[4] Univ Milan, Dept Pathophysiol & Transplantat, Milan, Italy

[5] Fdn IRCCS Ca Granda Osped Maggiore Policlin, Dept Internal Med, Resp Unit, Milan, Italy

[6] Fdn IRCCS Ca Granda Osped Maggiore Policlin, Cyst Fibrosis Adult Ctr, Milan, Italy

[7] Univ Hosp Gasthuisberg, Resp Med, Leuven, Belgium

[8] AZ Nikolaas Sint Niklaas, Resp Dis, St Niklaas, Belgium

[9] Royal Infirm Edinburgh NHS Trust, Edinburgh, Midlothian, Scotland

[10] Univ Edinburgh, Edinburgh, Midlothian, Scotland

[11] Univ Dundee, Scottish Ctr Resp Res, Dundee, Scotland

[12] Univ Novi Sad, Inst Pulm Dis Vojvodina Sremska Kamenica, Novi Sad, Serbia

[13] Univ Novi Sad, Fac Med, Novi Sad, Serbia

[14] Grifols Inc, Res Triangle Pk, NC USA

[15] Sotiria Chest Dis Hosp, Dept Pulm Med 5, Athens, Greece

[16] Hosp Valle De Hebron, DHebron Res Inst VHIR, Dept Resp Dis, Barcelona, Spain

[17] Newcastle Upon Tyne Hosp NHS Fdn Trust, Freeman Hosp, Adult Bronchiectasis Serv, Heaton, England

[18] Newcastle Upon Tyne Hosp NHS Fdn Trust, Freeman Hosp, Sir William Leech Ctr Lung Res, Heaton, England

[19] Newcastle Univ, Inst Cellular Med, Newcastle Upon Tyne, Tyne & Wear, England

[20] Galway Univ Hosp, Dept Resp Med, Galway, Ireland

来源：

EUROPEAN RESPIRATORY JOURNAL | 2018年 / 51卷 / 02期

关键词：

CYSTIC-FIBROSIS BRONCHIECTASIS; QUALITY-OF-LIFE; ADULT BRONCHIECTASIS; LUNG-FUNCTION; MORTALITY; COLONIZATION; PERSISTENCE; VALIDATION; COHORT; AIRWAY;

D O I：

10.1183/13993003.01953-2017

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

Pseudomonas aeruginosa is responsible for chronic infection in many bronchiectasis patients but it is not known whether it is associated with worse clinical outcomes independent of the underlying severity of disease. This study analysed data from 2596 bronchiectasis patients included from 10 different bronchiectasis clinical centres across Europe and Israel, with a 5-year follow-up period. Prevalence of P. aeruginosa chronic infection and its independent impact on exacerbations, hospitalisations, quality of life and mortality was assessed. The prevalence of P. aeruginosa chronic infection was 15.0% (n=389). P. aeruginosa was associated with a higher mortality in a univariate analysis (hazard ratio (HR) 2.02; 95% (confidence interval) CI 1.53-2.66; p<0.0001) but an independent impact on mortality was not found in a multivariate analysis (HR 0.98; 95% CI 0.70-1.36; p=0.89). P. aeruginosa was independently associated with increased mortality only in patients with frequent exacerbations (two or more per year) (HR 2.03; 95% CI 1.36-3.03; p=0.001). An independent association with worse quality of life of 7.46 points (95% CI 2.93-12.00; p=0.001) was found in a multivariable linear regression. P. aeruginosa was therefore found to be independently associated with exacerbation frequency, hospital admissions and worse quality of life. Mortality was increased in patients with P. aeruginosa particularly in the presence of frequent exacerbations.

引用

页数：10

共 30 条

[1] Clinical phenotypes in adult patients with bronchiectasis [J].