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Open AccessArticle

Chronic Bacterial Infection Prevalence, Risk Factors, and Characteristics: A Bronchiectasis Population-Based Prospective Study

1
Pulmonology Department, Centro Hospitalar S. João, 4200-319 Porto, Portugal
2
Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
3
Clinical Pathology Department, Centro Hospitalar S. João, 4200-319 Porto, Portugal
4
Radiology Department, Centro Hospitalar S. João, 4200-319 Porto, Portugal
5
Institute for Research and Innovation in Health (i3S), University of Porto, 4200-135 Porto, Portugal
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(3), 315; https://doi.org/10.3390/jcm8030315
Received: 15 February 2019 / Revised: 27 February 2019 / Accepted: 1 March 2019 / Published: 6 March 2019
Background: Few data are available on chronic bacterial infections (CBI) in bronchiectasis patients. Given that CBI seems to trigger longer hospital stays, worse outcomes, and morbimortality, this study was undertaken to assess CBI prevalence, characteristics, and risk factors in outpatients with bronchiectasis. Methods: A total of 186 patients followed in a bronchiectasis tertiary referral centre in Portugal were included. Demographic data and information on aetiology, smoking history, mMRC score, Bronchiectasis Severity Index (BSI) score, sputum characteristics, lung function, exacerbations, and radiological involvement degree were collected. Results: Patients included (mean age 54.7 ± 16.2 years; 60.8% females) were followed up for a period of 3.8 ± 1.7 years. The most common cause of bronchiectasis was infection (31.7%) followed by immune deficiencies (11.8%), whereas in 29% of cases, no cause was identified. Haemophilus influenzae (32.3%) and Pseudomonas aeruginosa (30.1%) were the most common CBI-associated possible pathogenic microorganisms. CBI patients presented a higher follow-up time than no-CBI patients (p = 0.003), worse lung function, BSI (p < 0.001), and radiological (p < 0.001) scores, and more prominent daily sputum production (p = 0.002), estimated mean volume (p < 0.001), and purulent sputum (p < 0.001). The number of exacerbations/year (p = 0.001), including those requiring hospital admission (p = 0.009), were also higher in the CBI group. Independent CBI predictors were BSI score (OR 3.577, 95% CI 1.233–10.378), sputum characteristics (OR 3.306, 95% CI 1.107–9.874), and radiological score (OR 1.052, 95% CI 1.004–1.102). Conclusion: According to the CBI status, two different sub-groups of patients were found on the basis of several clinical outcomes, emphasizing the importance of routine sputum microbiological monitoring. Further studies are needed to better characterize CBI profiles and to define the individual clinical impact of the most prevalent pathogenic microorganisms. View Full-Text
Keywords: bronchiectasis; chronic bacterial infection; Pseudomonas aeruginosa bronchiectasis; chronic bacterial infection; Pseudomonas aeruginosa
MDPI and ACS Style

Amorim, A.; Meira, L.; Redondo, M.; Ribeiro, M.; Castro, R.; Rodrigues, M.; Martins, N.; Hespanhol, V. Chronic Bacterial Infection Prevalence, Risk Factors, and Characteristics: A Bronchiectasis Population-Based Prospective Study. J. Clin. Med. 2019, 8, 315. https://doi.org/10.3390/jcm8030315

AMA Style

Amorim A, Meira L, Redondo M, Ribeiro M, Castro R, Rodrigues M, Martins N, Hespanhol V. Chronic Bacterial Infection Prevalence, Risk Factors, and Characteristics: A Bronchiectasis Population-Based Prospective Study. Journal of Clinical Medicine. 2019; 8(3):315. https://doi.org/10.3390/jcm8030315

Chicago/Turabian Style

Amorim, Adelina; Meira, Leonor; Redondo, Margarida; Ribeiro, Manuela; Castro, Ricardo; Rodrigues, Márcio; Martins, Natália; Hespanhol, Venceslau. 2019. "Chronic Bacterial Infection Prevalence, Risk Factors, and Characteristics: A Bronchiectasis Population-Based Prospective Study" J. Clin. Med. 8, no. 3: 315. https://doi.org/10.3390/jcm8030315

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