Risk Factors and Relation with Mortality of a New Acquisition and Persistence of <i>Pseudomonas aeruginosa</i> in COPD Patients

Martínez‐García, Miguel Ángel; Faner, Rosa; Oscullo, Grace; Rosa, David de la; Soler-Cataluña, Juan José; Ballester, Marta; Muriel, Alfonso; Agustí, Àlvar

doi:10.1080/15412555.2021.1884214

Cited by 17 publications

(26 citation statements)

References 40 publications

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“…Finally, this review included 8 studies 10 , 15–19 , 26 , 27 reporting on a total of 23,228 individuals (range 104 to 22,053) mainly conducted in Europe and USA. The studies included spanned over 20 years, with a follow-up ranging from 36 to 85 months and 6 had a prospective design.…”

Section: Resultsmentioning

confidence: 99%

“…Two studies included only severe COPD defined by FEV 1 % levels, 26 , 27 5 studies included moderate to severe COPD 10 , 15–17 , 19 and only one study 18 also included participants with mild disease ( Table 2 ). Six studies identified PA in sputum cultures 10 , 15–19 and 2 also used analysis of bacterial genomic DNA. 26 , 27 …”

Section: Resultsmentioning

confidence: 99%

“…There was scarce information on the prevalence of comorbidities, with the Charlson index ranging from 2.2 to 4. Asthma and bronchiectasis as primary diagnoses were explicit exclusion criteria in four studies, 10 , 16 , 17 , 19 while they were explicitly included in one, 15 and not mentioned in the remaining three studies ( Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…Assessment of the isolation of PA was conducted during an exacerbation 16 , 19 , 26 or, alternatively, other studies recruited COPD patients from outpatient clinics or healthcare databases, and PA isolation could either be conducted in a stable or exacerbated state. 10 , 15 , 17 , 18 , 27 …”

Section: Resultsmentioning

confidence: 99%

“…Pseudomonas aeruginosa (PA) is one of the most virulent PPM in terms of clinical outcomes and mortality in some chronic inflammatory airway diseases such as bronchiectasis 10 , 11 or cystic fibrosis, 12 in which the diagnosis and treatment of the infection by PA is the cornerstone of patient management. 13 , 14 However, the impact of PA infection on patients with stable COPD is controversial.…”

Section: Introductionmentioning

confidence: 99%

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Long-Term Risk of Mortality Associated with Isolation of Pseudomonas aeruginosa in COPD: A Systematic Review and Meta-Analysis

Martínez-García¹,

Rigau²,

Barrecheguren³

et al. 2022

COPD

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Background: Chronic bronchial infection is frequent in chronic obstructive pulmonary disease (COPD), but the impact of the isolation of pathogenic bacteria, and in particular Pseudomonas aeruginosa (PA) in respiratory samples on the prognosis of COPD is unclear. Methods: We conducted a systematic review of prognostic studies including patients with isolation of PA in sputum in stable state or during exacerbations of COPD. The main outcomes were all-cause mortality, respiratory mortality, and number and severity of future exacerbations. Data were expressed as hazard ratio (HR) (95% confidence interval [CI]) whenever possible. Results: Of 2773 studies, eight were finally included (23,228 individuals). The mean age ranged from 65.5 to 73 years. Six studies reported data for all-cause mortality. The adjusted risk of death was almost double in patients with PA isolation (HR 1.95, 95% CI, 1.34 to 2.84; quality of evidence moderate). Patients with PA isolation showed a three times higher adjusted risk of readmission at 30 days after discharge (OR 3.60, 95% CI, 3.60 to 12.03, 1 study; quality of evidence very low), and more than double adjusted risk of death and hospitalization at two years (HR 2.80, 95% CI, 2.20 to 3.56, 1 study; quality of evidence very low). Conclusion:There is moderate certainty that the isolation of PA in sputum is associated with an adjusted increased risk of death in patients with COPD.

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