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Does a single Pseudomonas aeruginosa isolation predict COPD mortality?

Boutou AK, Raste Y, Reid J, Alshafi K, Polkey MI, Hopkinson NS - Eur. Respir. J. (2014)

View Article: PubMed Central - PubMed

Affiliation: NIHR Respiratory Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London, UK afboutou@yahoo.com.

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To the Editor: Patients with chronic obstructive pulmonary disease (COPD) often suffer from acute exacerbations (AECOPD) of their disease, which have a significant impact on their health status... Pseudomonas aeruginosa can cause AECOPD and is associated with reduced survival in cystic fibrosis (CF) and bronchiectasis... Some studies have found that the presence of P... Arterial carbon dioxide tension (p=0.018) and exacerbation rate (p=0.008) were higher in the P... aeruginosa culture-positive patients compared to the P... aeruginosa sputum culture was correlated with a higher exacerbation frequency, it was not associated with a worse long-term outcome in COPD outpatients... Furthermore, careful patient matching has controlled for most of the lung function parameters that could affect mortality, so these negative results could not be attributed to a selected patient subgroup... In conclusion, this study indicated that a single P... aeruginosa sputum isolation is not a predictor of long-term mortality in a general COPD outpatient population... aeruginosa eradication using radical treatment, after its isolation in the sputum of a COPD patient with clinical deterioration or frequent exacerbations... Although eradicating Pseudomonas may be justified to improve health status, patients and clinicians can, to an extent, be reassured by these data that if this is not possible the impact on survival of a single P... aeruginosa isolation is not as significant as it is in CF or bronchiectasis.

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Kaplan–Meier survival curve for the Pseudomonas aeruginosa culture-positive and P. aeruginosa culture-negative groups. p=0.49 for P.aeruginosa culture-negative patients.
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erj-44-03-794-f01: Kaplan–Meier survival curve for the Pseudomonas aeruginosa culture-positive and P. aeruginosa culture-negative groups. p=0.49 for P.aeruginosa culture-negative patients.

Mentions: Median (range) survival for the study population (n=132) was 81.2 (50.8–109.5) months. During this period 51 (38.6%) patients died, of these 52.9% (n=27) were P.aeruginosa culture-positive and 47.1% (n=24) were P.aeruginosa culture-negative. The Kaplan–Meier survival curve, using the Log rank comparison, indicated that P.aeruginosa positive sputum culture was not associated with mortality in this population. Median (range) survival for P.aeruginosa culture-positive patients was 80.1 (40.1–120.1) months compared to 88.6 (52–125.3) months in the P.aeruginosa culture-negative patients (p=0.49) (fig. 1). Furthermore, no differences in survival as a function of the presence of Pseudomonas would have been identified if the entire population of 380 had been analysed (data not shown).


Does a single Pseudomonas aeruginosa isolation predict COPD mortality?

Boutou AK, Raste Y, Reid J, Alshafi K, Polkey MI, Hopkinson NS - Eur. Respir. J. (2014)

Kaplan–Meier survival curve for the Pseudomonas aeruginosa culture-positive and P. aeruginosa culture-negative groups. p=0.49 for P.aeruginosa culture-negative patients.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4150019&req=5

erj-44-03-794-f01: Kaplan–Meier survival curve for the Pseudomonas aeruginosa culture-positive and P. aeruginosa culture-negative groups. p=0.49 for P.aeruginosa culture-negative patients.
Mentions: Median (range) survival for the study population (n=132) was 81.2 (50.8–109.5) months. During this period 51 (38.6%) patients died, of these 52.9% (n=27) were P.aeruginosa culture-positive and 47.1% (n=24) were P.aeruginosa culture-negative. The Kaplan–Meier survival curve, using the Log rank comparison, indicated that P.aeruginosa positive sputum culture was not associated with mortality in this population. Median (range) survival for P.aeruginosa culture-positive patients was 80.1 (40.1–120.1) months compared to 88.6 (52–125.3) months in the P.aeruginosa culture-negative patients (p=0.49) (fig. 1). Furthermore, no differences in survival as a function of the presence of Pseudomonas would have been identified if the entire population of 380 had been analysed (data not shown).

View Article: PubMed Central - PubMed

Affiliation: NIHR Respiratory Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London, UK afboutou@yahoo.com.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

To the Editor: Patients with chronic obstructive pulmonary disease (COPD) often suffer from acute exacerbations (AECOPD) of their disease, which have a significant impact on their health status... Pseudomonas aeruginosa can cause AECOPD and is associated with reduced survival in cystic fibrosis (CF) and bronchiectasis... Some studies have found that the presence of P... Arterial carbon dioxide tension (p=0.018) and exacerbation rate (p=0.008) were higher in the P... aeruginosa culture-positive patients compared to the P... aeruginosa sputum culture was correlated with a higher exacerbation frequency, it was not associated with a worse long-term outcome in COPD outpatients... Furthermore, careful patient matching has controlled for most of the lung function parameters that could affect mortality, so these negative results could not be attributed to a selected patient subgroup... In conclusion, this study indicated that a single P... aeruginosa sputum isolation is not a predictor of long-term mortality in a general COPD outpatient population... aeruginosa eradication using radical treatment, after its isolation in the sputum of a COPD patient with clinical deterioration or frequent exacerbations... Although eradicating Pseudomonas may be justified to improve health status, patients and clinicians can, to an extent, be reassured by these data that if this is not possible the impact on survival of a single P... aeruginosa isolation is not as significant as it is in CF or bronchiectasis.

Show MeSH
Related in: MedlinePlus