Microbiologic follow-up study in adult bronchiectasis

• Published in: Respiratory medicine Vol. 101; no. 8; pp. 1633 - 1638
• Main Authors: King, Paul T, Holdsworth, Stephen R, Freezer, Nicholas J, Villanueva, Elmer, Holmes, Peter W
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01-08-2007; Elsevier; Elsevier Limited
• Subjects: Adult; Aged; Antibiotics; Bacteria; Biological and medical sciences; Bronchiectasis; Bronchiectasis - microbiology; Female; Haemophilus Infections - microbiology; Haemophilus influenzae - isolation & purification; Hospitals; Humans; Laboratories; Male; Medical sciences; Microbiology; Microorganisms; Middle Aged; Pneumology; Prospective Studies; Pseudomonas aeruginosa - isolation & purification; Pseudomonas Infections - microbiology; Pulmonary/Respiratory; Respiratory system : syndromes and miscellaneous diseases; Sputum; Sputum - microbiology; Statistical analysis; Statistical methods; Streptococcus infections; Studies; Microbiology; Bronchiectasis; Sputum; Human; Respiratory disease; Follow up study; Bronchus disease; Adult; Pneumology
• ISSN: 0954-6111; 1532-3064
• DOI: 10.1016/j.rmed.2007.03.009

Summary There is minimal published longitudinal data about pathogenic microorganisms in adults with bronchiectasis. Therefore a study was undertaken to assess the microbiologic profile over time in bronchiectasis. A prospective study of clinical and microbiologic outcomes was performed. Subjects were assessed by a respiratory physician and sputum sample were collected for analysis. Subjects were followed up and had repeat assessment performed. Eighty-nine subjects were followed up for a period of 5.7±3.6 years. On initial assessment the two most common pathogens isolated were Haemophilus influenzae (47%) and Pseudomonas aeruginosa (12%) whilst 21% had no pathogens isolated. On follow-up review results were similar (40% H. influenzae , 18% P. aeruginosa and 26% no pathogens). The prevalence of antibiotic resistance of isolates increased from 13% to 30%. Analysis of a series of H. influenzae isolates showed they were nearly all nontypeable and all were different subtypes. Subjects with no pathogens isolated from their sputum had the mildest disease, while subjects with P. aeruginosa had the most severe bronchiectasis. Many subjects with bronchiectasis are colonized with the same bacterium over an average follow-up of 5 years. Different pathogens are associated with different patterns of clinical disease.