Chronic bronchial infection associated with lung function decline in COPD
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Chronic bronchial infection by any pathogenic microorganism, and particularly with Pseudomonas aeruginosa, was identified as a risk factor for lung function decline among patients with COPD, researchers reported.
Miguel Angel Martinez-Garcia, MD, of the department of respiratory medicine at La Fe University and Polytechnic Hospital and the Biomedical Network Research Center at the Carlos III Health Institute in Spain, and colleagues conducted a post hoc analysis of a prospective cohort of 201 patients with COPD who were monitored every 3 to 6 months for 84 months.
Researchers defined chronic bronchial infection as three or more sputum positive cultures of the same pathogenic microorganism for 1 year. Patients were stratified at follow-up according to chronic bronchial infection by any pathogenic microorganism, as well as by isolation of P. aeruginosa.
During follow-up, 43.3% of patients did not have isolated pathogenic microorganisms, 23.9% had one isolation and 32.8% had chronic bronchial infection by any pathogenic microorganism.
In the entire cohort, FEV1 decline was 33.7 mL per year, which significantly increased to 57.1 mL per year in patients with chronic bronchial infection by any pathogenic microorganism and to 48.5 mL per year in patients in whom P. aeruginosa was isolated at least once.
The presence of chronic bronchial infection by any pathogenic microorganism and at least one P. aeruginosa isolation were identified by the researchers as independent factors associated with quicker decline in FEV1 when adjusted by baseline lung function, bronchiectasis, BMI, age, COPD exacerbations, smoking status, symptoms, baseline treatment and comorbidities.
“Future studies should validate these results in other COPD cohorts and investigate the impact of antibiotic treatment targeted to [chronic bronchial infection] and/or [P. aeruginosa] on FEV1 decline over time in patients with COPD,” the researchers wrote in Annals of the American Thoracic Society.