Details

Autor(en) / Beteiligte

• Macfarlane, J G
• McAlinden, P
• De Soyza, A

Titel

P240 Longitudinal study of sputum microbiology in adult non-CF bronchiectasis

Ist Teil von

• Thorax, 2010-12, Vol.65 (Suppl 4), p.A177-A178

Ort / Verlag

London: BMJ Publishing Group LTD

Erscheinungsjahr

2010

Link zum Volltext

Quelle

EZB-NALGM-00452 BMJ Journals Archive NL

Beschreibungen/Notizen

• Introduction and ObjectivesMonitoring longitudinal sputum microbiology in adults with non-CF bronchiectasis (nCF-Br) is a key strategy in guiding targeted antibiotic therapy. There is minimal published data on the microbiological profile over time in bronchiectasis.1 2 Similar to CF, greater pathogen diversity is now being observed; hence we have revisited this area.Methods12 years of previous sputum culture results obtained from 143 nCF-Br patients attending a specialist clinic were retrospectively reviewed. ‘Colonisation’ (organism cultured ≥2 occasions, 3 months apart within 1-year period) and ‘isolation’ (organism cultured ≥1) were recorded.Results88F, 55M patients; average age 60.6 (range 16–90); average FEV1 65% predicted (SD ± 26%). The most common pathogens were Haemophilus influenzae (52% isolated and 33% colonisation; 8% were beta-lactam producing) and Pseudomonas aeruginosa (43% isolated and 35% colonisation) whilst 20% patients had no pathogens cultured. 81 patients (57%) have never had Pseudomonas. Of 62 patients (43%) isolating Pseudomonas, 12 patients (8%) had single isolates, 8 (6%) had colonisation with successful eradication therapy. Streptococcus pneumoniae (34%), Coliforms (30%), Moraxella catarrhalis (27%), Staphylococcus aureus (24%) were other common isolates. Rarer pathogens include Aspergillus sp. (9%), S.maltophilia (8%), non-tuberculous mycobacteria (NTM 3%; M. terrae, M. avium and M. simiae), MRSA(3%), Acinetobacter sp. (3%) and Achromobacter xylosoxidans (3%).ConclusionsWe note similar rates of H. influenzae colonisation as previously (33% vs 40%1) but higher rates of Pseudomonas colonisation (35% vs 18%1 and 24%2). Including those with any prior Pseudomonas, the rates of Pseudomonas isolation reach as high as 43% (higher than reported at 31%2). Our unit receives referrals from the local immunodeficiency centre and other respiratory units but this is not felt to account for the high Pseudomonas rates. Ongoing surveillance of individual and geographically local microbiological profiles is important in managing patients with nCF-Br.Abstract P240 Table 1Longitudinal study of sputum microbiology in adult non-CF bronchiectasisIsolated*Colonising†Organismn (%)n (%)Haemophilus influenzae75 (52)47 (33)Pseudomonas aeruginosa62 (43)50 (35)Streptococcus pneumoniae42 (30)13 (9)Coliforms (including Klebsiella sp, Serratia sp, Proteus sp, E. Coli and Enterobacter cloacae)42 (30)13 (9)Moraxella catarrhalis39 (27)9 (6)Staphylococcus aureus34 (24)12 (8)Aspergillus sp.13 (9)3 (2)Stenotrophomonas maltophilia12 (8)2 (1)MRSA5 (3)3 (2)Acinetobacter sp.5 (3)3 (2)Achromobacter xylosoxidans4 (3)2 (1)Non-tuberculous mycobacteria4 (3)1 (0.7)Comamonas testosteroni2 (1)1 (0.7)Others9 (6)1 (0.7)No organism isolated28 (20)*Organism isolated from a patient one or more times within a 1-year period.†Organism cultured on at least two occasions, 3 months apart within a 1-year period.