Non cystic fibrosis bronchiectasis: A longitudinal retrospective observational cohort study of Pseudomonas persistence and resistance

McDonnell, Melissa; Jary, Hannah; Perry, Audrey; MacFarlane, James G.; Hester, Katy L.M.; Small, Therese; Molyneux, Sassy; Perry, John D.; Walton, Katherine; Soyza, Anthony De

doi:10.1016/j.rmed.2014.07.021

Cited by 122 publications

(129 citation statements)

References 35 publications

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“…However, no colonization with pathogens was detected in either of the patients with BE who died. McDonnell and colleagues reported that there was no relationship between colonization of P. aeruginosa and exacerbation rate in patients with BE (29). According to these data, MPA patients with BE had higher mortality rates due to respiratory infection in the late phase, even if the patients had not been colonized by any pathogens.…”

Section: Discussionmentioning

confidence: 97%

Characteristics and prognosis of microscopic polyangiitis with bronchiectasis

et al. 2017

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Background: Major pulmonary manifestations associated with microscopic polyangiitis (MPA) include diffuse alveolar hemorrhage (DAH) and interstitial pneumonia (IP).We previously showed bronchiectasis (BE) was one of the pulmonary complications of MPA. However, clinical features of BE patients with MPA are not fully understood. We investigated the characteristics and prognosis of BE patients with MPA.Methods: Forty-five MPA patients were retrospectively studied. The patients were divided into two groups:patients with BE and those without BE.Results: Thirty-one of 45 patients (69%) had pulmonary involvement including IP (23/45, 51%), BE (7/45, 16%), and DAH (5/45, 11%). There were no differences between the patients with BE versus those without with regard to clinical characteristics and initial treatments. However, the prognosis for patients with BE was better than those without BE during the first year after diagnosis, but it was worse between 1 and 5 years, which was statistically significant. Two BE patients died between 1 and 5 years as a result of pneumonia.Conclusions: BE as a complication of MPA might be related to lower mortality in the acute phase and higher mortality in the chronic phase compared to other pulmonary manifestations. More attention to pulmonary infection is needed for patients with BE during the chronic phase.

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Section: Discussionmentioning

confidence: 97%

Characteristics and prognosis of microscopic polyangiitis with bronchiectasis

et al. 2017

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“…In keeping with recommendations in cystic fibrosis, most specialist bronchiectasis centres will attempt eradication of P. aeruginosa upon first isolation [2]. Retrospective studies reporting high rates of P. aeruginosa eradication with treatment must be interpreted in light of data that suggests spontaneous clearance of P. aeruginosa occurs frequently in bronchiectasis both in clinical practice and in the placebo arms of randomized controlled trials [90,91]. Therefore the authors will typically perform a second sputum sample pre-treatment before commencing eradication [2] The BTS guidelines provides a useful algorithm for P. aeruginosa eradication [2].…”

Section: Eradicationmentioning

confidence: 99%

Management of bronchiectasis in adults

2015

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Formerly regarded as a rare disease, bronchiectasis is now increasingly recognised and a renewed interest in the condition is stimulating drug development and clinical research. Bronchiectasis represents the final common pathway of a number of infectious, genetic, autoimmune, developmental and allergic disorders and is highly heterogeneous in its aetiology, impact and prognosis.The goals of therapy should be: to improve airway mucus clearance through physiotherapy with or without adjunctive therapies; to suppress, eradicate and prevent airway bacterial colonisation; to reduce airway inflammation; and to improve physical functioning and quality of life.Fortunately, an increasing body of evidence supports interventions in bronchiectasis. The field has benefited greatly from the introduction of evidence-based guidelines in some European countries and randomised controlled trials have now demonstrated the benefit of long-term macrolide therapy, with accumulating evidence for inhaled therapies, physiotherapy and pulmonary rehabilitation.This review provides a critical update on the management of bronchiectasis focussing on emerging evidence and recent randomised controlled trials. @ERSpublications Bronchiectasis is a rapidly developing field: review of recent RCTs and progress towards developing new therapies

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“…P. aeruginosa colonisation defines a specific clinical phenotype of bronchiectasis, and is associated with a three-fold increase risk of death, a nearly seven-fold increase risk of hospital admissions, worse quality of life and more frequent exacerbations [27][28][29]. Evidence from CF suggests that attempts at eradication therapy targeting Pseudomonas can have success in converting patients to culture-negative status [30].…”

Section: Important Research Priorities Identified By Expertsmentioning

confidence: 99%

“…The role of NTM, between innocent colonisers or those causing chronic infection, and the predisposing factors to this need to be differentiated. There is also a paucity of data regarding the isolation of viruses and multiresistant bacteria [4,18,29]. The EMBARC registry is currently collecting susceptibility patterns of bacteria causing chronic infection in patients with bronchiectasis and these data will be crucial in planning further interventional studies on antibiotics at the European level [10].…”

Section: Consensus Statementmentioning

confidence: 99%

Research priorities in bronchiectasis: a consensus statement from the EMBARC Clinical Research Collaboration

et al. 2016

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Bronchiectasis is a disease of renewed interest in light of an increase in prevalence and increasing burden on international healthcare systems. There are no licensed therapies, and large gaps in knowledge in terms of epidemiology, pathophysiology and therapy. The European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) is a European Respiratory Society (ERS) Clinical Research Collaboration, funded by ERS to promote high-quality research in bronchiectasis. The objective of this consensus statement was to define research priorities in bronchiectasis. From 2014 to 2015, EMBARC used a modified Delphi process among European bronchiectasis experts to reach a consensus on 55 key research priorities in this field. During the same period, the European Lung Foundation collected 711 questionnaires from adult patients with bronchiectasis and their carers from 22 European countries reporting important research priorities from their perspective. This consensus statement reports recommendations for bronchiectasis research after integrating both physicians and patients priorities, as well as those uniquely identified by the two groups. Priorities identified in this consensus statement provide the clearest possible roadmap towards improving our understanding of the disease and the quality of care for patients with bronchiectasis. @ERSpublications EMBARC consensus statement identifies research priorities in bronchiectasis as determined by physicians and patients

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Non cystic fibrosis bronchiectasis: A longitudinal retrospective observational cohort study of Pseudomonas persistence and resistance

Cited by 122 publications

References 35 publications

Characteristics and prognosis of microscopic polyangiitis with bronchiectasis

Characteristics and prognosis of microscopic polyangiitis with bronchiectasis

Management of bronchiectasis in adults

Research priorities in bronchiectasis: a consensus statement from the EMBARC Clinical Research Collaboration

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