Pseudomonas aeruginosa and risk of death and exacerbations in patients with chronic obstructive pulmonary disease: an observational cohort study of 22 053 patients

Abstract

a b s t r a c tObjectives: The role of Pseudomonas aeruginosa in the long-term prognosis of chronic obstructive pulmonary disease (COPD) is unknown. The purpose of this study was to determine whether P. aeruginosa is associated with increased risk of exacerbations or death in patients with COPD. Methods: This is a multiregional epidemiological study based on complete data on COPD outpatients between 1 January 2010 and 31 October 2017 and corresponding microbiology and national register data. Time-dependent Cox proportional hazards models and propensity matching was used to estimate hospitalization-demanding exacerbations and death after 2 years, separately and in combination. Results: A total of 22 053 COPD outpatients were followed for a median of 1082 days (interquartilerange: 427e1862). P. aeruginosa was present in 905 (4.1%) patients. During 730 days of follow-up, P. aeruginosa strongly and independently predicted an increased risk of hospitalization for exacerbation or all-cause death (HR 2.8, 95%CI 2.2e3.6; p <0.0001) and all-cause death (HR 2.7, 95%CI 2.3e3.4; p <0.0001) in analyses adjusted for known and suspected confounders. The signal remained unchanged in unadjusted analyses as well as propensity-matched subgroup analyses. Among patients 'ever colonized' with P. aeruginosa, the incidence of hospital-demanding exacerbations doubled after the time of the first colonization. Conclusions: COPD patients in whom P. aeruginosa can be cultured from the airways had a markedly increased risk of exacerbations and death. It is still not clear whether this risk can be reduced by offering patients targeted antipseudomonal antibiotics. A randomized trial is currently recruiting patients to clarify this (ClinicalTrials.gov: NCT03262142).

<p>The Underlying Role of Mitophagy in Different Regulatory Mechanisms of Chronic Obstructive Pulmonary Disease</p>

“…59 Researchers constructed a large observational study to show that the colonization of Pseudomonas aeruginosa increased the risk of hospitalization for exacerbated COPD, increasing COPD mortality. 87 Deficient mitophagy is associated with immune cell homeostasis and inflammatory cytokine secretion, which contribute to autoimmune disease pathologies. 14 Pathogens can directly modulate mitophagy, and pathogenic components can influence the innate immune response, which promotes pathogen replication in host cells.…”

Quercetin negatively regulates IL-1β production in Pseudomonas aeruginosa-infected human macrophages through the inhibition of MAPK/NLRP3 inflammasome pathways

“…Pseudomonas aeruginosa is a Gram-negative bacterium and an opportunistic pathogen capable of infecting humans with compromised host defense mechanisms [1] and causing serious infections and even death [2][3][4]. Of particular concern are chronic lung infections of patients with cystic fibrosis (CF), a genetic disease that increases susceptibility to respiratory infection [5,6].…”

Bioprocessing and integration of a high flux screening systematic platform based on isothermal amplification for the detection on 8 common pathogens

“…Pathogens mediated infectious diseases in human beings and animals remain a major concern in public health [1]. During a large variety of common pathogens, E. coli, P. aeruginosa, S. aureus (especially methicillin-resistant Staphylococcus aureus, MRSA), coagulase-negative staphylococci (MRCNS), V. parahaemolyticus, L. monocytogenes and Salmonella are the leading pathogens responsible for large number of human infections and diseases [2][3][4][5][6][7][8][9][10][11][12][13][14][15]. However, bacterial identification of such pathogens requires up to several days [16].…”