Pseudomonas aeruginosa is a bacterium usually not found in COPD patients. According to a previous study, pathogens frequently found in sputum of patients with COPD exacerbations include Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae, Klebsiella pneumoniae, and Escherichia coli[2].
Dr Josefin Eklöf (Copenhagen University Hospital) presented the results of a multiregional epidemiological study, which assessed the role of P. aeruginosa in 22,053 COPD outpatients. Samples from the lower respiratory tract (e.g. sputum, tracheal secretion, bronchial secretion, and bronchial alveolar lavage) were examined for the presence of P. aeruginosa. The germ could be identified in 905 patients (4.1%) of the total cohort. All study participants were followed for a median time of 1,082 days, and hospitalisation for exacerbation and all-cause mortality were compared between patients with and without P. aeruginosa.
Compared with the patients who did not harbour P. aeruginosa, those with P. aeruginosa had a significant higher risk for exacerbation or all-cause death. Of the COPD patients with P. aeruginosa, 80% were hospitalised compared with 48% of patients without P. aeruginosa (P<0.0001). The difference between the groups with regard to all-cause mortality was also striking: 22% in patients positive for P. aeruginosa compared with 18% in P. aeruginosa-negative patients (P<0.0001). These results were robust even after adjusting for well-known confounders.
The authors conclude that P. aeruginosa is associated with substantially worsened long-term prognosis in COPD. They advocate a randomised controlled trial to conclude whether targeted antibiotic interventions can improve the prognosis of this high-risk group of COPD patients.
- Eklöf J, et al. PA2887, ERS 2019, 29 Sept-2 Oct, Madrid, Spain.
- Vesna Cukic. Mater Sociomed 2013;25(4):226-9.
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Table of Contents: ERS 2019
Featured articles
Letter from the Editor
Interview with ERS president Prof. Tobias Welte
Holistic View on Asthma
Holistic view on asthma
COPD Management
COPD patients derive clinical benefit from β-blockers
COPD patients harbouring Pseudomonas Aeruginosa face high risk of hospitalisation
One blood eosinophil count is sufficient to guide ICS therapy
Female COPD patients frequently suffer from anxiety and depression
Dual bronchodilation improves ventilation dynamics in COPD patients
Vaping
Vaping impairs innate immune response of the airway
Alternative nicotine delivery products: no help in smoking cessation
Air Pollution
Pregnant women and their offspring: a high-risk group for air pollution
Taxi drivers exposed to highest levels of black carbon pollution
Infectious Respiratory Disease: the Role of Vaccines
Vaccines show multiple positive effects with respect to respiratory health
Pneumococcal vaccines: an effective way to reduce COPD hospitalisations
Interstitial Lung Disease
Antifibrotic therapy slows disease progression in ILD
Reduction of FVC decline in systemic sclerosis-associated ILD
Registry confirms nintedanib efficacy under real-life conditions
Best of the Posters
Fever during immunotherapy for NSCLC associated with shorter PFS
Smart shirt as a device to measure tidal volumes in real-life setting
Exercise with virtual reality beneficial for COPD patients
NSCLC: A new way to evaluate hilar and mediastinal lymph nodes
COPD patients do not benefit from azithromycin therapy longer than a year
Novel Developments in Infectious Disease
Long-term azithromycin decreases exacerbations in primary ciliary dyskinesia
Predicting community-acquired pneumonia outcomes by microRNA testing
Pulmonary Vascular Disease
Balloon pulmonary angioplasty for inoperable chronic thromboembolic pulmonary hypertension
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