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Role of Stenotrophomonas maltophilia isolation in patients with non-CF bronchiectasis
R Marra1, G Sgalla2, L Richeldi1,2
1Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Rome 00168, Italy.
Introduction:
Stenotrophomonas maltophilia is a bacteria whose role in patients with cystic fibrosis (CF) bronchiectasis has been previously studied; little is known about its role in non-CF bronchiectasis.
Materials And Methods:
Aim of our study is to investigate the risk factors for S. maltophilia acquisition and its clinical impact on bronchiectasis patients. A retrospective observational cohort study enrolling patients attending the Bronchiectasis Clinic at the Royal Infirmary of Edinburgh, Scotland, UK. A total of 167 bronchiectasis patients undergoing intravenous (IV) antibiotic therapy were selected and divided according to single or chronic S. maltophilia isolation in sputum. The risk factors and prognostic impact were studied.
Results:
Single isolation was independently associated with lower baseline % predicted forced expiratory volume in 1 s [odds ratio (OR) 0.98; 95% confidence interval (CI) 0.970-1.044; P = 0.025] and with less radiological involvement (OR 0.379; 95% CI 0.175-0.819; P = 0.01). Chronic isolation was associated with the number of IV antibiotic courses in the year before and after the first isolation (OR 1.2; 95% CI 1.053-1.398; P = 0.007) and with the absence of Pseudomonas aeruginosa colonization (OR 0.207; 95% CI 0.056-0.764; P = 0.02). In the chronic isolation group, there were more exacerbations and more need of IV antibiotics in the year after the first isolation.
Conclusions:
Poor lung function is the main independent risk factor for single isolation of S. maltophilia. For chronic colonization, the main independent risk factor is the number of IV antibiotic courses and the absence of P. aeruginosa chronic colonization. Only when chronically present, S. maltophilia had a clinical impact with more exacerbations.
Insights
Stenotrophomonas maltophilia (S. maltophilia) isolation in bronchiectasis patients is linked to lung function and antibiotic use. Chronic S. maltophilia colonization increases exacerbations, unlike single instances.
Area of Science:
- Medical Microbiology
- Pulmonology
- Infectious Diseases
Background:
- Stenotrophomonas maltophilia (S. maltophilia) is a bacterium with a known role in cystic fibrosis (CF) bronchiectasis.
- Its impact on non-CF bronchiectasis remains less understood.
Purpose of the Study:
- To investigate risk factors for S. maltophilia acquisition in bronchiectasis patients.
- To determine the clinical impact of S. maltophilia in this population.
Main Methods:
- Retrospective observational cohort study of 167 bronchiectasis patients.
- Patients were categorized by single or chronic S. maltophilia isolation in sputum.
- Analysis of risk factors and prognostic impact.
Main Results:
- Poor lung function (lower FEV1) was associated with single S. maltophilia isolation.
- Chronic isolation correlated with increased intravenous (IV) antibiotic courses and absence of Pseudomonas aeruginosa.
- The chronic isolation group experienced more exacerbations and required more IV antibiotics.
Conclusions:
- Reduced lung function is a key risk factor for single S. maltophilia isolation.
- Frequent IV antibiotic use and lack of P. aeruginosa colonization are risk factors for chronic S. maltophilia.
- Chronic S. maltophilia presence significantly increases exacerbations in bronchiectasis patients.
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