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Pseudomonas aeruginosa in Chronic Obstructive Pulmonary Disease Patients with Frequent Hospitalized Exacerbations: A Prospective Multicentre Study.
- Source :
-
Respiration . Oct2018, Vol. 96 Issue 5, p417-424. 8p. 1 Diagram, 2 Charts, 1 Graph. - Publication Year :
- 2018
-
Abstract
- 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. [ABSTRACT FROM AUTHOR]
- Subjects :
- *ADRENOCORTICAL hormones
*CONFIDENCE intervals
*DISEASE susceptibility
*LONGITUDINAL method
*OBSTRUCTIVE lung diseases
*MEDICAL cooperation
*SCIENTIFIC observation
*PSEUDOMONAS diseases
*RESEARCH
*SPUTUM
*DISEASE prevalence
*DISEASE exacerbation
*PATIENT readmissions
*DESCRIPTIVE statistics
*ODDS ratio
*DISEASE complications
*DISEASE risk factors
*THERAPEUTICS
Subjects
Details
- Language :
- English
- ISSN :
- 00257931
- Volume :
- 96
- Issue :
- 5
- Database :
- Academic Search Index
- Journal :
- Respiration
- Publication Type :
- Academic Journal
- Accession number :
- 132806981
- Full Text :
- https://doi.org/10.1159/000490190