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Lobar distribution in non-cystic fibrosis bronchiectasis predicts bacteriologic pathogen treatment

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European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript


Non-cystic fibrosis bronchiectasis (NCFBr) is a major cause of morbidity due to frequent infectious exacerbations. We analyzed the influence of patient age and bronchiectasis location on the bacterial profile of patients with NCFBr. This retrospective cohort study included 339 subjects diagnosed with an infectious exacerbation of NCFBr during the 9-year period between January 2006 and December 2014. Bronchoalveolar lavage (BAL) cultures and high-resolution computed tomography scans (HRCT) were utilized to characterize the location of the bronchiectasis and bacteriologic pathogenic profile. In univariate logistic regression, the frequency of Haemophilus influenzae was higher in patients aged ≤64 years (OR = 0.969, p < 0.0001, 95 % CI 0.954–0.983), whereas the frequency of Pseudomonas aeruginosa (OR = 1.027, p = 0.008, 95 % CI 1.007–1.048) and Enterobacteriaceae (OR = 1.039, p = 0.01, 95 % CI 1.009–1.069) were significantly higher in patients aged >64 years. The lobar distribution of bronchiectasis in the subjects was 25.9 % in the right middle lobe (RML), 20.7 % in the right lower lobe (RLL), 20.4 % in the left lower lobe (LLL), 13.8 % in the lingula, 13 % in the right upper lobe (RUL), and 6.2 % in the left upper lobe (LUL). In the lower lobes, H. influenzae was the dominant species isolated, whereas in the RUL it was P. aeruginosa and in the LUL it was non- tuberculous mycobacterium (NTM). H. influenzae was more prevalent in younger patients, whereas P. aeruginosa, Enterobacteriaceae and NTM predominated in older patients. Different pathogens were associated with different lobar distributions. The RML, RLL and LLL showed a greater tendency to develop bronchiectasis than other lobes.

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  1. King PT, Holdsworth SR, Freezer NJ, Villanueva E, Holmes PW (2007) Microbiologic follow-up study in adult bronchiectasis. Respir Med 101(8):1633–1638. doi:10.1016/j.rmed.2007.03.009

    Article  PubMed  Google Scholar 

  2. Angrill J, Agusti C, de Celis R, Rano A, Gonzalez J, Sole T, Xaubet A, Rodriguez-Roisin R, Torres A (2002) Bacterial colonisation in patients with bronchiectasis: microbiological pattern and risk factors. Thorax 57(1):15–19

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Palwatwichai A, Chaoprasong C, Vattanathum A, Wongsa A, Jatakanon A (2002) Clinical, laboratory findings and microbiologic characterization of bronchiectasis in Thai patients. Respirology 7(1):63–66

    Article  PubMed  Google Scholar 

  4. Wilson CB, Jones PW, O'Leary CJ, Hansell DM, Cole PJ, Wilson R (1997) Effect of sputum bacteriology on the quality of life of patients with bronchiectasis. Eur Respir J 10(8):1754–1760

    Article  CAS  PubMed  Google Scholar 

  5. Davies G, Wells AU, Doffman S, Watanabe S, Wilson R (2006) The effect of Pseudomonas aeruginosa on pulmonary function in patients with bronchiectasis. Eur Respir J 28(5):974–979. doi:10.1183/09031936.06.00074605

    Article  CAS  PubMed  Google Scholar 

  6. McDonnell MJ, Jary HR, Perry A, MacFarlane JG, Hester KL, Small T, Molyneux C, Perry JD, Walton KE, De Soyza A (2015) Non cystic fibrosis bronchiectasis: a longitudinal retrospective observational cohort study of Pseudomonas persistence and resistance. Respir Med 109(6):716–726. doi:10.1016/j.rmed.2014.07.021

    Article  PubMed  Google Scholar 

  7. McGuinness G, Naidich DP (2002) CT of airways disease and bronchiectasis. Radiol Clin North Am 40(1):1–19

    Article  PubMed  Google Scholar 

  8. National Committee for Clinical Laboratory Standards (1998) Performance standards for antimicrobial susceptibility testing; NCCLS document M100-S8, 18(1). The Committee; 8th information supplement, Villanova

    Google Scholar 

  9. Loebinger MR, Wells AU, Hansell DM, Chinyanganya N, Devaraj A, Meister M, Wilson R (2009) Mortality in bronchiectasis: a long-term study assessing the factors influencing survival. Eur Respir J 34(4):843–849. doi:10.1183/09031936.00003709

    Article  CAS  PubMed  Google Scholar 

  10. Pasteur MC, Helliwell SM, Houghton SJ, Webb SC, Foweraker JE, Coulden RA, Flower CD, Bilton D, Keogan MT (2000) An investigation into causative factors in patients with bronchiectasis. Am J Respir Crit Care Med 162(4 Pt 1):1277–1284

    Article  CAS  PubMed  Google Scholar 

  11. Chan CH, Ho AK, Chan RC, Cheung H, Cheng AF (1992) Mycobacteria as a cause of infective exacerbation in bronchiectasis. Postgrad Med J 68(805):896–9

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Wickremasinghe M, Ozerovitch L, Davies G, Wodehouse T, Chadwick M, Abdallah S, Shah P, Wilson R (2005) Non-tuberculous mycobacteria in patients with bronchiectasis. Thorax 60(12):1045–1051

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Correspondence to S. Izhakian.

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The authors declare no conflicts of interest.

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The study received ethical approval by the Helsinki Committee of the Rabin Medical Center Petach Tikvah, Israel.

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Written informed consent was not required in this observational, retrospective study as per guidelines of the Rabin Medical Center Institutional Review Board.

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Izhakian, S., Wasser, W.G., Fuks, L. et al. Lobar distribution in non-cystic fibrosis bronchiectasis predicts bacteriologic pathogen treatment. Eur J Clin Microbiol Infect Dis 35, 791–796 (2016).

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