Effect of sputum bacteriology on the quality of life of patients with bronchiectasis

Abstract

Bronchiectatic patients have impaired health-related quality of life (QoL) and are prone to chronic lower respiratory tract infections. We have investigated whether impaired QoL is related to sputum bacteriology.Eighty seven patients with non-cystic fibrosis (non-CF) bronchiectasis, in a stable phase of their illness, completed three QoL measures, underwent a computed tomography (CT) scan and lung function tests, and provided a fresh sputum sample for microscopy and culture.The QoL of patients colonized by Pseudomonas aeruginosa (Pa group) was significantly worse than all other patients grouped together (non-Pa group), and specifically those infected by Haemophilus influenzae (Hi group) or who had no bacterial growth (NG group) (p<0.05), but not those infected by other bacterial species (O group). The Pa group had worse lung function, but no significant differences were found between the groups for forced expiratory volume in one second (FEV1) and peak expiratory flow rate. The Pa group had significantly worse bronchiectasis scores than the O, NG and non-Pa groups, but not the Hi group. There were no significant differences between the groups with respect to the number of infective exacerbations in the last year, but the Pa group had significantly more hospital admissions. Patients infected by P. aeruginosa for more than 3 yrs had significantly worse FEV1 (p<0.03) and bronchiectasis scores (p<0.05) than those infected with P. aeruginosa for less time, but not significantly worse QoL.We conclude that, overall, patients infected with P. aeruginosa have worse quality of life, and that P. aeruginosa is associated with a greater extent of disease and worse lung function. Although patients infected with H. influenzae had extensive bronchiectasis their quality of life was better than the P. aeruginosa infected group.

Does airway colonization cause systemic inflammation in bronchiectasis?

“…The most commonly accused microorganism with disease severity and worse clinical outcome in bronchiectasis is P. aeruginosa. The presence of this microorganism during stable period is related with more extensive disease, severe airflow limitation and rapid decline in lung function (20,(22)(23)(24)(25). Consistently, in this study, patients with P. aeruginosa colonization had more impairment in pulmonary function tests and more diffuse disease on HRCT.…”

Non-CF bronchiectasis: does knowing the aetiology lead to changes in management?

“…WILSON et al [29] and HERNANDEZ et al [30] both found that patients infected with P. aeruginosa had a greater extent of lung disease and worse lung function than uncolonised patients. In the current study, no relationships between lung function and microbial infection were demonstrated in the patients.…”

Pseudomonas aeruginosa, cyanide accumulation and lung function in CF and non-CF bronchiectasis patients

“…The end result of chronic infection and inflammation is bronchiectasis, irreversible dilation of the bronchial tree with mucus plugging. Other groups of patients with non-CF bronchiectasis also have a high rate of infection with P. aeruginosa, which is similarly associated with increased disease severity and poorer quality of life [6].…”