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Pseudomonas aeruginosa resistance patterns and clinical outcomes in hospitalized exacerbations of COPD.
- Source :
-
Respirology (Carlton, Vic.) [Respirology] 2016 Oct; Vol. 21 (7), pp. 1235-42. Date of Electronic Publication: 2016 Jun 20. - Publication Year :
- 2016
-
Abstract
- Background and Objective: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) due to Pseudomonas aeruginosa (PA) are associated with worse outcomes. PA antibiotic resistance is important to determine treatment and may influence clinical outcomes. The aim was to study clinical characteristics and outcomes in patients with AECOPD associated with PA based on their antibiotic resistance.<br />Methods: This was a prospective observational study including all patients with AECOPD and positive PA sputum culture admitted in a respiratory ward in a tertiary hospital in Barcelona during 2013-2014. PA was defined as resistant (PA-R) when the antibiogram showed ≥1 resistance.<br />Results: Four hundred one patients with AECOPD were evaluated. Of them, 54 (13%) had a positive PA sputum culture. Eighty-two per cent were men, median age was 77 (SD 7) years old and FEV1 was less than 36% (SD 17) of predicted value. PA-R was isolated in 35 patients (66%), and PA-sensitive (PA-S) was isolated in 18 (34%) patients. No differences were found in demographics, lung function and comorbidities among groups. PA-R patients were more likely exposed to prior oral corticosteroids (77% vs 44%, P = 0.03) and antibiotics (77% vs 31%, P = 0.01), respectively. AECOPD patients associated with PA-S were more likely to die at 30 days (odds ratio 13.53, 95% confidence interval: 1.14-69.56, P = 0.03) and 90 days (odds ratio 7.09, 95% confidence interval: 1.33-37.89, P = 0.02), respectively.<br />Conclusion: Pseudomonas aeruginosa-resistant affects patients with severe AECOPD and previous use of corticosteroids and antibiotics. The presence of PA-S is associated with higher mortality. These results may suggest increased virulence in PA-S strains causing acute infections.<br /> (© 2016 Asian Pacific Society of Respirology.)
- Subjects :
- Aged
Aged, 80 and over
Anti-Bacterial Agents therapeutic use
Female
Hospitalization statistics & numerical data
Humans
Male
Odds Ratio
Prospective Studies
Risk Factors
Spain epidemiology
Sputum microbiology
Drug Resistance, Microbial
Pseudomonas aeruginosa drug effects
Pseudomonas aeruginosa isolation & purification
Pulmonary Disease, Chronic Obstructive diagnosis
Pulmonary Disease, Chronic Obstructive epidemiology
Pulmonary Disease, Chronic Obstructive microbiology
Pulmonary Disease, Chronic Obstructive therapy
Symptom Flare Up
Subjects
Details
- Language :
- English
- ISSN :
- 1440-1843
- Volume :
- 21
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Respirology (Carlton, Vic.)
- Publication Type :
- Academic Journal
- Accession number :
- 27325555
- Full Text :
- https://doi.org/10.1111/resp.12825