Forskning
Udskriv Udskriv
Switch language
Rigshospitalet - en del af Københavns Universitetshospital
Udgivet

Pseudomonas aeruginosa and risk of death and exacerbations in patients with chronic obstructive pulmonary disease: an observational cohort study of 22.053 patients

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. Oral amoxicillin and amoxicillin–clavulanic acid: properties, indications, and usage

    Publikation: Bidrag til tidsskriftReviewForskningpeer review

  2. Understanding the microbiome of diabetic foot osteomyelitis: insights from molecular and microscopic approaches

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Multicentre determination of rezafungin (CD101) susceptibility of Candida species by the EUCAST method

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Infectious meningitis and encephalitis in adults in Denmark: A prospective nationwide observational cohort study (DASGIB)

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  • J Eklöf
  • R Sørensen
  • T S Ingebrigtsen
  • P Sivapalan
  • I Achir
  • J B Boel
  • J Bangsborg
  • C Ostergaard
  • R B Dessau
  • U S Jensen
  • A Browatzki
  • T S Lapperre
  • J Janner
  • U M Weinreich
  • K Armbruster
  • T Wilcke
  • N Seersholm
  • J U S Jensen
Vis graf over relationer

OBJECTIVES: 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 (interquartile-range: 427-1862). 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 2.2-3.6; p <0.0001) and all-cause death (HR 2.7, 95%CI 2.3-3.4; 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).

OriginalsprogEngelsk
TidsskriftClinical Microbiology and Infection
Vol/bind26
Udgave nummer2
Sider (fra-til)227-234
ISSN1198-743X
DOI
StatusUdgivet - 2020

ID: 57456165