Background
Methods
Study subjects
COPD clinical evaluation
Bronchiectasis assessment
Sputum bacteriology
P. aeruginosagenotyping
Statistical analysis
Results
Population sample
Whole group | PA-group | Non PA-group | P value | |
---|---|---|---|---|
Subjects, (%)
| 118 | 41 (34.7) | 77 (65,3) | … |
Follow-up (days), m (SD)
| 1003±306 | 1036.9±347.5 | 984.9±282.3 | 0.41 |
Age (years), m (SD)
| 69.5±8.2 | 70.3±7.7 | 69±8.5 | 0.42 |
Current smoking, (%)
| 13 (11) | 2 (4.9) | 11 (14.3) | 0.21 |
Pack-year, m (SD)
| 63.3±31,9 | 69.4±36.3 | 60±28.9 | 0.15 |
Alcohol abuse >80 g/l, n (%)
| 3 (2.5) | 1 (2.4) | 2 (2.6) | 1 |
Influenza vaccination, n (%)
| 105 (89) | 38 (92.7) | 67 (87) | 0.53 |
Pneumococcus vaccination n (%)
| 57 (48.3) | 23 (56.1) | 34 (44.2) | 0.21 |
Body mass index (Kgr/m
2
)
| 27.5±4.6 | 26.5±4 | 28.1±4.9 | 0.17 |
FEV1 post-BD, (L), m (SD)
| 0.97±0.3 | 0.91±0.28 | 1.0±0.31 | 0.13 |
FEV1 post-BD, (% predicted), m (SD)
| 34±11 | 34±13 | 34.3±10 | 0.82 |
GOLD stage IV, n (%)
| 71 (60) | 27 (66) | 44 (57) | 0.35 |
BODE score, m (SD)
| 5.1±1,6 | 5.3±1,5 | 5±1.6 | 0.38 |
Home oxygen therapy, n (%)
| 50 (42.4) | 21 (51.2) | 29 (37.7) | 0.15 |
Charlson, m (SD)
| 4.13±1.5 | 4.29±1.5 | 4.04±1.5 | 0.39 |
Bronchiectasis score, m (SD)
| 2.1±2,6 | 3±3.5 | 1.6±1.8 |
0.02
|
ECOPD during follow-up, m (SD)
| 3.19±2.9 | 4.4±4 | 2.5±2 |
0.008
|
ECOPD/year, m (SD)
| 2.19±2 | 3±2.7 | 1.7±1.4 |
0.006
|
Antibiotic prescriptions*
| 8.9±7.5 | 12.5±9.2 | 7.01±5.7 |
<0.001
|
Antibiotic prescriptions/year
| 3.3±2.5 | 4.7±2.9 | 2.6±1.8 |
<0.001
|
Corticosteroid courses*
| 6.3±5.8 | 8±6.3 | 5.5±5.4 |
0.02
|
Corticosteroid courses/year
| 2.30±1.8 | 2.9±2 | 1.9±1.6 |
0.004
|
Days of hospital stay*
| 29.4±37.9 | 43.8±43.9 | 21.3±31.9 |
0.005
|
Mortality, n (%)
| 17 (14.4) | 11 (27) | 6 (8) |
0.005
|
Prevalence and risk factors for P. aeruginosaisolation
Factor | OR | 95% CI | P value |
---|---|---|---|
Bronchiectasis score (>5) |
9.8
|
1.7 - 54.8
|
0.009
|
Antibiotic prescriptions/year |
1.7
|
1.1 – 2.5
|
0.008
|
Days of hospital stay | 1 | 0.9 - 1 | 0.3 |
Corticosteroid courses/year | 0.7 | 0.5 – 1.2 | 0.2 |
P. aeruginosacolonization and bronchiectasis
Characterization of P. aeruginosaisolates
Patient isolates | PFGE Genotype | ECOPD | Isolation date | Morphotype |
---|---|---|---|---|
1e | P16 | No | 24/Mar/06 |
Pseudomonas aeruginosa
|
1f | P32 | No | 24/Mar/06 |
Pseudomonas aeruginosa
|
1a | P16 | Yes | 10/Jan/07 |
Pseudomonas aeruginosa
|
1b | P16 | No | 16/Feb/07 |
Pseudomonas aeruginosa
|
1g | P16 | Yes | 21/Mar/07 |
Pseudomonas aeruginosa
|
1i | P16 | Yes | 21/Mar/07 |
Pseudomonas aeruginosa mucoid |
1c | P16 | Yes | 23/Apr/07 |
Pseudomonas aeruginosa mucoid |
1d | P16 | Yes | 31/May/07 |
Pseudomonas aeruginosa
|
25a | P26a1
| Yes | 18/Aug/05 |
Pseudomonas aeruginosa mucoid |
25b | P26a1
| No | 3/Nov/05 |
Pseudomonas aeruginosa mucoid |
25c | P26a1
| Yes | 5/Dec/05 |
Pseudomonas aeruginosa
|
25d | P26a1
| No | 9/Jan/06 |
Pseudomonas aeruginosa mucoid |
25e | P26a2
| No | 17/Mar/06 |
Pseudomonas aeruginosa mucoid |
25f | P26a1
| Yes | 11/Jan/07 |
Pseudomonas aeruginosa mucoid |
25g | P26b
| Yes | 23/Apr/07 |
Pseudomonas aeruginosa mucoid |
26a | P27 | Yes | 10/Oct/07 |
Pseudomonas aeruginosa
|
26b | P27 | Yes | 12/Nov/07 |
Pseudomonas aeruginosa
|
26c | P27 | No | 14/Dec/07 |
Pseudomonas aeruginosa
|
29a | P30a2
| Yes | 2/Mar/05 |
Pseudomonas aeruginosa
|
29b | P30a2
| No | 17/Jun/05 |
Pseudomonas aeruginosa
|
29c | P30a2
| Yes | 9/Nov/05 |
Pseudomonas aeruginosa
|
29k | P30a1
| Yes | 12/Dec/05 |
Pseudomonas aeruginosa
|
29l | P30a2
| Yes | 12/Dec/05 |
Pseudomonas aeruginosa
|
29d | P30a1
| No | 23/Jan/06 |
Pseudomonas aeruginosa
|
29e | P30b | No | 3/Jul/06 |
Pseudomonas aeruginosa
|
29f | P30a1
| No | 18/Sep/06 |
Pseudomonas aeruginosa
|
29g | P30a2
| No | 7/Nov/06 |
Pseudomonas aeruginosa
|
29h | P30a2
| No | 27/Dec/06 |
Pseudomonas aeruginosa
|
29i | P30b
| No | 12/Sep/07 |
Pseudomonas aeruginosa
|
29j | P30b
| No | 17/Dec/07 |
Pseudomonas aeruginosa
|
31a | P06b
| Yes | 9/Oct/06 |
Pseudomonas aeruginosa
|
31b | P06b
| No | 21/Nov/06 |
Pseudomonas aeruginosa
|
31c | P06a
| Yes | 22/Mar/07 |
Pseudomonas aeruginosa
|
31d | P06a
| No | 27/Apr/07 |
Pseudomonas aeruginosa
|
31e | P06a
| Yes | 4/Sep/07 |
Pseudomonas aeruginosa
|
31f | P06b
| No | 17/Oct/07 |
Pseudomonas aeruginosa
|
Patient isolates | PFGE Genotype | ECOPD | Isolation date | Morphotype |
---|---|---|---|---|
2a | P14 | Yes | 17/Oct/06 |
Pseudomonas aeruginosa
|
2b | P33 | Yes | 15/Feb/08 |
Pseudomonas aeruginosa
|
3 | P19 | Yes | 17/Oct/05 |
Pseudomonas aeruginosa
|
4 | P10 | Yes | 2/Jun/05 |
Pseudomonas aeruginosa
|
5 | P04a
| Yes | 22/Mar/06 |
Pseudomonas aeruginosa
|
6 | P23 | Yes | 4/Jul/05 |
Pseudomonas aeruginosa
|
7a | P07 | Yes | 1/Dec/06 |
Pseudomonas aeruginosa
|
7b | P07 | No | 12/Nov/07 |
Pseudomonas aeruginosa
|
8a | P31 | No | 8/Sep/05 |
Pseudomonas aeruginosa
|
8b | P31 | No | 12/Dec/05 |
Pseudomonas aeruginosa
|
9 | P12 | Yes | 14/Dec/07 |
Pseudomonas aeruginosa
|
10 | P28 | Yes | 10/Aug/06 |
Pseudomonas aeruginosa
|
11 | P29 | Yes | 5/Oct/07 |
Pseudomonas aeruginosa
|
12a | P13 | Yes | 7/Apr/05 |
Pseudomonas aeruginosa
|
12b | P13 | No | 18/Oct/05 |
Pseudomonas aeruginosa
|
13a | P34 | Yes | 30/May/06 |
Pseudomonas aeruginosa
|
13b | P02 | Yes | 11/Oct/06 |
Pseudomonas aeruginosa
|
14a | P18 | Yes | 28/Jan/06 |
Pseudomonas aeruginosa
|
14b | P18 | Yes | 28/Jul/06 |
Pseudomonas aeruginosa
|
15 | P05 | Yes | 2/Feb/06 |
Pseudomonas aeruginosa
|
16a | P15 | Yes | 23/Nov/05 |
Pseudomonas aeruginosa
|
16b | P15 | Yes | 3/Jan/06 |
Pseudomonas aeruginosa
|
17a | P20 | Yes | 3/Nov/05 |
Pseudomonas aeruginosa
|
17b | P20 | Yes | 22/Dec/05 |
Pseudomonas aeruginosa
|
17c | P20 | Yes | 8/Jun/06 |
Pseudomonas aeruginosa
|
19a | P25 | Yes | 19/Dec/05 |
Pseudomonas aeruginosa
|
19b | P35 | No | 12/Jun/06 |
Pseudomonas aeruginosa
|
19c | P17 | Yes | 3/Mar/08 |
Pseudomonas aeruginosa
|
20 | P03 | Yes | 28/Nov/06 |
Pseudomonas aeruginosa
|
21 | P01 | Yes | 4/Feb/08 |
Pseudomonas aeruginosa
|
23 | P24 | Yes | 6/Mar/06 |
Pseudomonas aeruginosa
|
24 | P09 | Yes | 30/Jun/06 |
Pseudomonas aeruginosa
|
27a | P08 | Yes | 20/Mar/06 |
Pseudomonas aeruginosa
|
27b | P08 | No | 12/Apr/06 |
Pseudomonas aeruginosa
|
27c | P08 | No | 25/Jul/07 |
Pseudomonas aeruginosa
|
28 | P11 | Yes | 11/Oct/07 |
Pseudomonas aeruginosa mucoid |
30a | P04a
| Yes | 10/Jan/07 |
Pseudomonas aeruginosa
|
30b | P04b
| No | 21/Feb/07 |
Pseudomonas aeruginosa mucoid |
30c | P22 | No | 19/Dec/07 |
Pseudomonas aeruginosa
|
30d | P22 | Yes | 8/Feb/08 |
Pseudomonas aeruginosa
|
36 | P36 | Yes | 23/May/05 |
Pseudomonas aeruginosa mucoid |
32 | P21 | Yes | 10/Nov/06 |
Pseudomonas aeruginosa
|
Antibiotic group | Antibiotic | Number of susceptible strains (%) |
---|---|---|
Quinolones
| 39 (50.0) | |
Ciprofloxacin | 37 (47.4) | |
Levofloxacin | 39 (50.0) | |
Aminoglycosides
| 63 (80.8) | |
Tobramycin | 54 (69.2) | |
Amikacin | 61 (78.2) | |
Gentamicin | 37 (47.4) | |
Penicillins
| 63 (80.8) | |
Ticarcillin | 58 (74.4) | |
Piperacillin tazobactam | 63 (80.8) | |
Cefalosphorins
| 58 (74.4) | |
Ceftazidime | 58 (74.4) | |
Cefepime | 51 (65.4) | |
Carbapenems
| 62 (79.5) | |
Imipenem | 50 (64.1) | |
Meropenem | 62 (79.5) | |
Polymyxins
| Colistin | 76 (97.4) |
Monobactams
| Aztreonam | 59 (75.6) |