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Start Over Author "Rodrigo-Troyano, A." Topic pseudomonas aeruginosa
18 results on '"Rodrigo-Troyano, A."'

1. Identification of Pseudomonas aeruginosa and airway bacterial colonization by an electronic nose in bronchiectasis.

Author

Suarez-Cuartin G, Giner J, Merino JL, Rodrigo-Troyano A, Feliu A, Perea L, Sanchez-Reus F, Castillo D, Plaza V, Chalmers JD, and Sibila O

Subjects
Aged, Analysis of Variance, Bronchi microbiology, Bronchiectasis physiopathology, Cross-Sectional Studies, Female, Forced Expiratory Volume physiology, Humans, Male, Middle Aged, Pseudomonas Infections physiopathology, Vital Capacity physiology, Bronchiectasis microbiology, Electronic Nose, Pseudomonas Infections diagnosis, Pseudomonas aeruginosa isolation & purification
Abstract

Rationale: Airway colonization by Potentially Pathogenic Microorganisms (PPM) in bronchiectasis is associated with worse clinical outcomes. The electronic nose is a non-invasive technology capable of distinguishing volatile organic compounds (VOC) in exhaled breath. We aim to explore if an electronic nose can reliably discriminate airway bacterial colonization in patients with bronchiectasis., Methods: Seventy-three clinically stable bronchiectasis patients were included. PPM presence was determined using sputum culture. Exhaled breath was collected in Tedlar bags and VOC breath-prints were detected by the electronic nose Cyranose 320 ® . Raw data was reduced to three factors with principal component analysis. Univariate ANOVA followed by post-hoc least significant difference test was performed with these factors. Patients were then classified using linear canonical discriminant analysis. Cross-validation accuracy values were defined by the percentage of correctly classified patients., Results: Forty-one (56%) patients were colonized with PPM. Pseudomonas aeruginosa (n = 27, 66%) and Haemophilus influenzae (n = 7, 17%) were the most common PPM. VOC breath-prints from colonized and non-colonized patients were significantly different (accuracy of 72%, AUROC 0.75, p < 0.001). VOC breath-prints from Pseudomonas aeruginosa colonized patients were significantly different from those of patients colonized with other PPM (accuracy of 89%, AUROC 0.97, p < 0.001) and non-colonized patients (accuracy 73%, AUROC 0.83, p = 0.007)., Conclusions: An electronic nose can accurately identify VOC breath-prints of clinically stable bronchiectasis patients with airway bacterial colonization, especially in those with Pseudomonas aeruginosa., (Copyright © 2018. Published by Elsevier Ltd.)

Published
2018
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2. Pseudomonas aeruginosa in Chronic Obstructive Pulmonary Disease Patients with Frequent Hospitalized Exacerbations: A Prospective Multicentre Study.

Author

Rodrigo-Troyano A, Melo V, Marcos PJ, Laserna E, Peiro M, Suarez-Cuartin G, Perea L, Feliu A, Plaza V, Faverio P, Restrepo MI, Anzueto A, and Sibila O

Subjects
Aged, Aged, 80 and over, Disease Progression, Drug Resistance, Bacterial, Female, Humans, Male, Prospective Studies, Pseudomonas Infections complications, Pseudomonas aeruginosa, Pulmonary Disease, Chronic Obstructive microbiology
Abstract

Background: Pseudomonas aeruginosa (PA) is a common microorganism related to severe exacerbations in Chronic Obstructive Pulmonary Disease (COPD). However, their role in COPD patients with frequent hospitalized exacerbations (FHE) is not well described., Objectives: We aimed to determine prevalence, risk factors, susceptibility patterns and impact on outcomes of PA in COPD patients with FHE., Methods: Prospective observational multicentre study that included COPD patients with FHE. The cohort was stratified in 2 groups according to the presence or absence of PA isolation in sputum. Patients were followed up for 12 months., Results: We enrolled 207 COPD patients with FHE. In 119 patients (57%), a valid sputum culture was collected. Of them, PA was isolated in 21 patients (18%). The risk factors associated with PA were prior use of systemic corticosteroids (OR 3.3, 95% CI 1.2-9.7, p = 0.01) and prior isolation of PA (OR 4.36, 95% CI 1.4-13.4, p < 0.01). Patients with PA had an increased risk of having ≥3 readmissions (OR 4.1, 95% CI 1.3-12.8, p = 0.01) and higher PA isolation rate (OR 7.7, 95% CI 2.4-24.6, p < 0.001) during the follow-up period. In 14 patients (67%), PA was resistant to at least one antibiotic tested. PA persisted in the sputum in 70% of patients., Conclusions: The presence of PA was related to 3 or more readmissions during the 1-year follow-up and PA persisted in the sputum despite an appropriate antibiotic treatment. This finding suggested an important role of PA in the course of the disease of COPD patients with FHE., (© 2018 S. Karger AG, Basel.)

Published
2018
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3. Pseudomonas aeruginosa resistance patterns and clinical outcomes in hospitalized exacerbations of COPD.

Author

Rodrigo-Troyano A, Suarez-Cuartin G, Peiró M, Barril S, Castillo D, Sanchez-Reus F, Plaza V, Restrepo MI, Chalmers JD, and Sibila O

Subjects
Aged, Aged, 80 and over, Anti-Bacterial Agents therapeutic use, Female, Hospitalization statistics & numerical data, Humans, Male, Odds Ratio, Prospective Studies, Risk Factors, Spain epidemiology, Sputum microbiology, Drug Resistance, Microbial, Pseudomonas aeruginosa drug effects, Pseudomonas aeruginosa isolation & purification, Pulmonary Disease, Chronic Obstructive diagnosis, Pulmonary Disease, Chronic Obstructive epidemiology, Pulmonary Disease, Chronic Obstructive microbiology, Pulmonary Disease, Chronic Obstructive therapy, Symptom Flare Up
Abstract

Background and Objective: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) due to Pseudomonas aeruginosa (PA) are associated with worse outcomes. PA antibiotic resistance is important to determine treatment and may influence clinical outcomes. The aim was to study clinical characteristics and outcomes in patients with AECOPD associated with PA based on their antibiotic resistance., Methods: This was a prospective observational study including all patients with AECOPD and positive PA sputum culture admitted in a respiratory ward in a tertiary hospital in Barcelona during 2013-2014. PA was defined as resistant (PA-R) when the antibiogram showed ≥1 resistance., Results: Four hundred one patients with AECOPD were evaluated. Of them, 54 (13%) had a positive PA sputum culture. Eighty-two per cent were men, median age was 77 (SD 7) years old and FEV1 was less than 36% (SD 17) of predicted value. PA-R was isolated in 35 patients (66%), and PA-sensitive (PA-S) was isolated in 18 (34%) patients. No differences were found in demographics, lung function and comorbidities among groups. PA-R patients were more likely exposed to prior oral corticosteroids (77% vs 44%, P = 0.03) and antibiotics (77% vs 31%, P = 0.01), respectively. AECOPD patients associated with PA-S were more likely to die at 30 days (odds ratio 13.53, 95% confidence interval: 1.14-69.56, P = 0.03) and 90 days (odds ratio 7.09, 95% confidence interval: 1.33-37.89, P = 0.02), respectively., Conclusion: Pseudomonas aeruginosa-resistant affects patients with severe AECOPD and previous use of corticosteroids and antibiotics. The presence of PA-S is associated with higher mortality. These results may suggest increased virulence in PA-S strains causing acute infections., (© 2016 Asian Pacific Society of Respirology.)

Published
2016
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4. Antimicrobial peptides, disease severity and exacerbations in bronchiectasis

Author

Martina Oriano, Ana Rodrigo-Troyano, Guillermo Suarez-Cuartin, Lidia Perea, Holly R. Keir, Oriol Sibila, Stefano Aliberti, Elisabet Cantó, Diane Cassidy, Francesco Blasi, Amelia Shoemark, James D. Chalmers, Silvia Vidal, A. T. H. Smith, and Samantha Ong

Subjects
Male, Pulmonary and Respiratory Medicine, Exacerbation, medicine.medical_treatment, medicine.disease_cause, Severity of Illness Index, Cathelicidin, Proinflammatory cytokine, 03 medical and health sciences, 0302 clinical medicine, Cathelicidins, medicine, Humans, Secretory Leukocyte Peptidase Inhibitor, Prospective Studies, Aged, 030304 developmental biology, 0303 health sciences, Bronchiectasis, biology, Pseudomonas aeruginosa, Lactoferrin, business.industry, Sputum, medicine.disease, Europe, Phenotype, 030228 respiratory system, Immunology, Disease Progression, biology.protein, Female, Muramidase, medicine.symptom, business, Biomarkers, Antimicrobial Cationic Peptides, SLPI
Abstract

RationaleRecently a frequent exacerbator phenotype has been described in bronchiectasis, but the underlying biological mechanisms are unknown. Antimicrobial peptides (AMPs) are important in host defence against microbes but can be proinflammatory in chronic lung disease.ObjectivesTo determine pulmonary and systemic levels of AMP and their relationship with disease severity and future risk of exacerbations in bronchiectasis.MethodsA total of 135 adults with bronchiectasis were prospectively enrolled at three European centres. Levels of cathelicidin LL-37, lactoferrin, lysozyme and secretory leucocyte protease inhibitor (SLPI) in serum and sputum were determined at baseline by ELISA. Patients were followed up for 12 months. We examined the ability of sputum AMP to predict future exacerbation risk.Measurements and main resultsAMP levels were higher in sputum than in serum, suggesting local AMP release. Patients with more severe disease at baseline had dysregulation of airway AMP. Higher LL-37 and lower SLPI levels were associated with Bronchiectasis Severity Index, lower FEV1 (forced expiratory volume in 1 s) and Pseudomonas aeruginosa infection. Low SLPI levels were also associated with the exacerbation frequency at baseline. During follow-up, higher LL-37 and lower SLPI levels were associated with a shorter time to the next exacerbation, whereas LL-37 alone predicted exacerbation frequency over the next 12 months.ConclusionsPatients with bronchiectasis showed dysregulated sputum AMP levels, characterised by elevated LL-37 and reduced SLPI levels in the frequent exacerbator phenotype. Elevated LL-37 and reduced SLPI levels are associated with Pseudomonas aeruginosa infection and can predict future risk of exacerbations in bronchiectasis.

Published
2019
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5. Carga y factores de riesgo para la neumonía adquirida en la comunidad de Pseudomonas aeruginosa : un estudio multinacional de prevalencia puntual de pacientes hospitalizados

Author

Restrepo M. I., Babu B. L., Reyes L. F., Chalmers J. D., Soni N. J., Sibila O., Faverio P., Cilloniz C., Rodriguez-Cintron W., Aliberti S., Aruj P. K., Attorri S., Barimboim E., Caeiro J. P., Garzon M. I., Cambursano V. H., Ceccato A., Chertcoff J., Lascar F., Di Tulio F., Diaz A. C., de Vedia L., Ganaha M. C., Lambert S., Lopardo G., Luna C. M., Malberti A. G., Morcillo N., Tartara S., Pensotti C., Pereyra B., Scapellato P. G., Stagnaro J. P., Shah S., Lotsch F., Thalhammer F., Anseeuw K., Francois C. A., Van Braeckel E., Vincent J. L., Djimon M. Z., Bashi J., Dodo R., Nouer S. A., Chipev P., Encheva M., Miteva D., Petkova D., Dodo Balkissou A., Pefura Yone E. W., Mbatchou Ngahane B. H., Shen N., Xu J. F., Bustamante Rico C. A., Buitrago R., Pereira Paternina F. J., Kayembe Ntumba J. M., Carevic V. V., Jakopovic M., Jankovic M., Matkovic Z., Mitrecic I., Bouchy Jacobsson M. L., Bro Christensen A., Heitmann Bodtger U. C., Niels Meyer C., Vestergaard Jensen A., Baunbaek-Knudsen G., Petersen P. T., Andersen S., Abd El-Wahhab I. E., Elsayed Morsy N., Shafiek H., Sobh E., Abdella Abdulsemed K., Bertrand F., Brun-Buisson C., de Montmollin E., Fartoukh M., Messika J., Tattevin P., Khoury A., Ebruke B., Dreher M., Kolditz M., Meisinger M., Pletz M. W., Hagel S., Rupp J., Schaberg T., Spielmanns M., Creutz P., Suttorp N., Siaw-Lartey B., Dimakou K., Papapetrou D., Tsigou E., Ampazis D., Kaimakamis E., Bhatia M., Dhar R., D'Souza G., Garg R., Koul P. A., Mahesh P. A., Jayaraj B. S., Narayan K. V., Udnur H. B., Krishnamurthy S. B., Kant S., Swarnakar R., Limaye S., Salvi S., Golshani K., Keatings V. M., Martin-Loeches I., Maor Y., Strahilevitz J., Battaglia S., Carrabba M., Ceriana P., Confalonieri M., Monforte A. D., Del Prato B., De Rosa M., Fantini R., Fiorentino G., Gammino M. A., Menzella F., Milani G., Nava S., Palmiero G., Petrino R., Gabrielli B., Rossi P., Sorino C., Steinhilber G., Zanforlin A., Franzetti F., Carugati M., Morosi M., Monge E., Carone M., Patella V., Scarlata S., Comel A., Kurahashi K., Bacha Z. A., Ugalde D. B., Zuniga O. C., Villegas J. F., Medenica M., van de Garde E. M. W., Raj Mihsra D., Shrestha P., Ridgeon E., Awokola B. I., Nwankwo O. N. O., Olufunlola A. B., Olumide S., Ukwaja K. N., Irfan M., Minarowski L., Szymon S., Froes F., Leuschner P., Meireles M., Ferrao C., Neves J., Ravara S. B., Brocovschii V., Ion C., Rusu D., Toma C., Chirita D., Dorobat C. M., Birkun A., Kaluzhenina A., Almotairi A., Ali Bukhary Z. A., Edathodu J., Fathy A., Abdulaziz Enani A. M., Mohamed N. E., Memon J. U., Bella A., Bogdanovic N., Milenkovic B., Pesut D., Feldman C., Yum H. K., Borderias L., Bordon Garcia N. M., Cabello Alarcon H., Torres A., Diaz-Brito V., Casas X., Gonzalez A. E., Fernandez-Almira M. L., Gallego M., Gaspar-Garcia I., Del Castillo J. G., Victoria P. J., Martinez E. L., de Molina R. M., Marcos P. J., Menendez R., Pando-Sandoval A., Aymerich C. P., de la Torre A. L., Garcia-Olive I., Rello J., Moyano S., Sanz F., Rodrigo-Troyano A., Sole-Violan J., Uranga A., van Boven J. F. M., Torra E. V., Pujol J. A., Fiogbe A. A., Yangui F., Bilaceroglu S., Dalar L., Yilmaz U., Bogomolov A., Elahi N., Dhasmana D. J., Feneley A., Ions R., Skeemer J., Woltmann G., Hancock C., Hill A. T., Rudran B., Ruiz-Buitrago S., Campbell M., Whitaker P., Youzguin A., Singanayagam A., Allen K. S., Brito V., Dietz J., Dysart C. E., Kellie S. M., Zablocki C. J., MurphyMurphy R. G., Franco-Sadud R. A., Meier G., Gaga M., Holland T. L., Bergin S. P., Kheir F., Landmeier M., Lois M., Nair G. B., Patel H., Saito S., Noda J., Hinojosa C. I., Levine S. M., Angel L. F., Anzueto A., Whitlow K. S., Hipskind J., Sukhija K., Totten V., Wunderink R. G., Shah R. D., Mateyo K. J., Noriega L., Alvarado E., Aman M., Labra L., Restrepo, M. I., Babu, B. L., Reyes, L. F., Chalmers, J. D., Soni, N. J., Sibila, O., Faverio, P., Cilloniz, C., Rodriguez-Cintron, W., Aliberti, S., Aruj, P. K., Attorri, S., Barimboim, E., Caeiro, J. P., Garzon, M. I., Cambursano, V. H., Ceccato, A., Chertcoff, J., Lascar, F., Di Tulio, F., Diaz, A. C., de Vedia, L., Ganaha, M. C., Lambert, S., Lopardo, G., Luna, C. M., Malberti, A. G., Morcillo, N., Tartara, S., Pensotti, C., Pereyra, B., Scapellato, P. G., Stagnaro, J. P., Shah, S., Lotsch, F., Thalhammer, F., Anseeuw, K., Francois, C. A., Van Braeckel, E., Vincent, J. L., Djimon, M. Z., Bashi, J., Dodo, R., Nouer, S. A., Chipev, P., Encheva, M., Miteva, D., Petkova, D., Dodo Balkissou, A., Pefura Yone, E. W., Mbatchou Ngahane, B. H., Shen, N., Xu, J. F., Bustamante Rico, C. A., Buitrago, R., Pereira Paternina, F. J., Kayembe Ntumba, J. M., Carevic, V. V., Jakopovic, M., Jankovic, M., Matkovic, Z., Mitrecic, I., Bouchy Jacobsson, M. L., Bro Christensen, A., Heitmann Bodtger, U. C., Niels Meyer, C., Vestergaard Jensen, A., Baunbaek-Knudsen, G., Petersen, P. T., Andersen, S., Abd El-Wahhab, I. E., Elsayed Morsy, N., Shafiek, H., Sobh, E., Abdella Abdulsemed, K., Bertrand, F., Brun-Buisson, C., de Montmollin, E., Fartoukh, M., Messika, J., Tattevin, P., Khoury, A., Ebruke, B., Dreher, M., Kolditz, M., Meisinger, M., Pletz, M. W., Hagel, S., Rupp, J., Schaberg, T., Spielmanns, M., Creutz, P., Suttorp, N., Siaw-Lartey, B., Dimakou, K., Papapetrou, D., Tsigou, E., Ampazis, D., Kaimakamis, E., Bhatia, M., Dhar, R., D'Souza, G., Garg, R., Koul, P. A., Mahesh, P. A., Jayaraj, B. S., Narayan, K. V., Udnur, H. B., Krishnamurthy, S. B., Kant, S., Swarnakar, R., Limaye, S., Salvi, S., Golshani, K., Keatings, V. M., Martin-Loeches, I., Maor, Y., Strahilevitz, J., Battaglia, S., Carrabba, M., Ceriana, P., Confalonieri, M., Monforte, A. D., Del Prato, B., De Rosa, M., Fantini, R., Fiorentino, G., Gammino, M. A., Menzella, F., Milani, G., Nava, S., Palmiero, G., Petrino, R., Gabrielli, B., Rossi, P., Sorino, C., Steinhilber, G., Zanforlin, A., Franzetti, F., Carugati, M., Morosi, M., Monge, E., Carone, M., Patella, V., Scarlata, S., Comel, A., Kurahashi, K., Bacha, Z. A., Ugalde, D. B., Zuniga, O. C., Villegas, J. F., Medenica, M., van de Garde, E. M. W., Raj Mihsra, D., Shrestha, P., Ridgeon, E., Awokola, B. I., Nwankwo, O. N. O., Olufunlola, A. B., Olumide, S., Ukwaja, K. N., Irfan, M., Minarowski, L., Szymon, S., Froes, F., Leuschner, P., Meireles, M., Ferrao, C., Neves, J., Ravara, S. B., Brocovschii, V., Ion, C., Rusu, D., Toma, C., Chirita, D., Dorobat, C. M., Birkun, A., Kaluzhenina, A., Almotairi, A., Ali Bukhary, Z. A., Edathodu, J., Fathy, A., Abdulaziz Enani, A. M., Mohamed, N. E., Memon, J. U., Bella, A., Bogdanovic, N., Milenkovic, B., Pesut, D., Feldman, C., Yum, H. K., Borderias, L., Bordon Garcia, N. M., Cabello Alarcon, H., Torres, A., Diaz-Brito, V., Casas, X., Gonzalez, A. E., Fernandez-Almira, M. L., Gallego, M., Gaspar-Garcia, I., Del Castillo, J. G., Victoria, P. J., Martinez, E. L., de Molina, R. M., Marcos, P. J., Menendez, R., Pando-Sandoval, A., Aymerich, C. P., de la Torre, A. L., Garcia-Olive, I., Rello, J., Moyano, S., Sanz, F., Rodrigo-Troyano, A., Sole-Violan, J., Uranga, A., van Boven, J. F. M., Torra, E. V., Pujol, J. A., Fiogbe, A. A., Yangui, F., Bilaceroglu, S., Dalar, L., Yilmaz, U., Bogomolov, A., Elahi, N., Dhasmana, D. J., Feneley, A., Ions, R., Skeemer, J., Woltmann, G., Hancock, C., Hill, A. T., Rudran, B., Ruiz-Buitrago, S., Campbell, M., Whitaker, P., Youzguin, A., Singanayagam, A., Allen, K. S., Brito, V., Dietz, J., Dysart, C. E., Kellie, S. M., Zablocki, C. J., Murphymurphy, R. G., Franco-Sadud, R. A., Meier, G., Gaga, M., Holland, T. L., Bergin, S. P., Kheir, F., Landmeier, M., Lois, M., Nair, G. B., Patel, H., Saito, S., Noda, J., Hinojosa, C. I., Levine, S. M., Angel, L. F., Anzueto, A., Whitlow, K. S., Hipskind, J., Sukhija, K., Totten, V., Wunderink, R. G., Shah, R. D., Mateyo, K. J., Noriega, L., Alvarado, E., Aman, M., Labra, L., Restrepo, M, Babu, B, Reyes, L, Chalmers, J, Soni, N, Sibila, O, Faverio, P, Cilloniz, C, Rodriguez-Cintron, W, Aliberti, S, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Groningen Research Institute for Asthma and COPD (GRIAC), Restrepo M.I., Babu B.L., Reyes L.F., Chalmers J.D., Soni N.J., Sibila O., Faverio P., Cilloniz C., Rodriguez-Cintron W., Aliberti S., Aruj P.K., Attorri S., Barimboim E., Caeiro J.P., Garzon M.I., Cambursano V.H., Ceccato A., Chertcoff J., Lascar F., Di Tulio F., Diaz A.C., de Vedia L., Ganaha M.C., Lambert S., Lopardo G., Luna C.M., Malberti A.G., Morcillo N., Tartara S., Pensotti C., Pereyra B., Scapellato P.G., Stagnaro J.P., Shah S., Lotsch F., Thalhammer F., Anseeuw K., Francois C.A., Van Braeckel E., Vincent J.L., Djimon M.Z., Bashi J., Dodo R., Nouer S.A., Chipev P., Encheva M., Miteva D., Petkova D., Dodo Balkissou A., Pefura Yone E.W., Mbatchou Ngahane B.H., Shen N., Xu J.F., Bustamante Rico C.A., Buitrago R., Pereira Paternina F.J., Kayembe Ntumba J.M., Carevic V.V., Jakopovic M., Jankovic M., Matkovic Z., Mitrecic I., Bouchy Jacobsson M.L., Bro Christensen A., Heitmann Bodtger U.C., Niels Meyer C., Vestergaard Jensen A., Baunbaek-Knudsen G., Petersen P.T., Andersen S., Abd El-Wahhab I.E., Elsayed Morsy N., Shafiek H., Sobh E., Abdella Abdulsemed K., Bertrand F., Brun-Buisson C., de Montmollin E., Fartoukh M., Messika J., Tattevin P., Khoury A., Ebruke B., Dreher M., Kolditz M., Meisinger M., Pletz M.W., Hagel S., Rupp J., Schaberg T., Spielmanns M., Creutz P., Suttorp N., Siaw-Lartey B., Dimakou K., Papapetrou D., Tsigou E., Ampazis D., Kaimakamis E., Bhatia M., Dhar R., D'Souza G., Garg R., Koul P.A., Mahesh P.A., Jayaraj B.S., Narayan K.V., Udnur H.B., Krishnamurthy S.B., Kant S., Swarnakar R., Limaye S., Salvi S., Golshani K., Keatings V.M., Martin-Loeches I., Maor Y., Strahilevitz J., Battaglia S., Carrabba M., Ceriana P., Confalonieri M., Monforte A.D., Del Prato B., De Rosa M., Fantini R., Fiorentino G., Gammino M.A., Menzella F., Milani G., Nava S., Palmiero G., Petrino R., Gabrielli B., Rossi P., Sorino C., Steinhilber G., Zanforlin A., Franzetti F., Carugati M., Morosi M., Monge E., Carone M., Patella V., Scarlata S., Comel A., Kurahashi K., Bacha Z.A., Ugalde D.B., Zuniga O.C., Villegas J.F., Medenica M., van de Garde E.M.W., Raj Mihsra D., Shrestha P., Ridgeon E., Awokola B.I., Nwankwo O.N.O., Olufunlola A.B., Olumide S., Ukwaja K.N., Irfan M., Minarowski L., Szymon S., Froes F., Leuschner P., Meireles M., Ferrao C., Neves J., Ravara S.B., Brocovschii V., Ion C., Rusu D., Toma C., Chirita D., Dorobat C.M., Birkun A., Kaluzhenina A., Almotairi A., Ali Bukhary Z.A., Edathodu J., Fathy A., Abdulaziz Enani A.M., Mohamed N.E., Memon J.U., Bella A., Bogdanovic N., Milenkovic B., Pesut D., Feldman C., Yum H.K., Borderias L., Bordon Garcia N.M., Cabello Alarcon H., Torres A., Diaz-Brito V., Casas X., Gonzalez A.E., Fernandez-Almira M.L., Gallego M., Gaspar-Garcia I., Del Castillo J.G., Victoria P.J., Martinez E.L., de Molina R.M., Marcos P.J., Menendez R., Pando-Sandoval A., Aymerich C.P., de la Torre A.L., Garcia-Olive I., Rello J., Moyano S., Sanz F., Rodrigo-Troyano A., Sole-Violan J., Uranga A., van Boven J.F.M., Torra E.V., Pujol J.A., Fiogbe A.A., Yangui F., Bilaceroglu S., Dalar L., Yilmaz U., Bogomolov A., Elahi N., Dhasmana D.J., Feneley A., Ions R., Skeemer J., Woltmann G., Hancock C., Hill A.T., Rudran B., Ruiz-Buitrago S., Campbell M., Whitaker P., Youzguin A., Singanayagam A., Allen K.S., Brito V., Dietz J., Dysart C.E., Kellie S.M., Zablocki C.J., MurphyMurphy R.G., Franco-Sadud R.A., Meier G., Gaga M., Holland T.L., Bergin S.P., Kheir F., Landmeier M., Lois M., Nair G.B., Patel H., Saito S., Noda J., Hinojosa C.I., Levine S.M., Angel L.F., Anzueto A., Whitlow K.S., Hipskind J., Sukhija K., Totten V., Wunderink R.G., Shah R.D., Mateyo K.J., Noriega L., Alvarado E., Aman M., and Labra L.

Subjects
Pneumonia, Pseudomonas aeruginosa, Male, antibiotic resistance, Internationality, Cross-sectional study, bacterial colonization, very elderly, Prevalence, Drug Resistance, Drug resistance, Pneumònia adquirida a la comunitat, Pseudomonas aeruginosa community acquired pneumonia, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Tracheostomy, Community-acquired pneumonia, Risk Factors, Epidemiology, 80 and over, Medicine, Community-Acquired Infection, 030212 general & internal medicine, Aged, 80 and over, Cross Infection, adult, article, Bacterial, Middle Aged, Antibiotic coverage, Bronchiectasis, Community-Acquired Infections, hospital patient, priority journal, risk factor, Aged, Cross-Sectional Studies, Drug Resistance, Bacterial, Female, Humans, Logistic Models, Pneumonia, Bacterial, Pseudomonas aeruginosa, Infectious diseases, Human, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Chronic Obstructive, Logistic Model, Admission, Settore MED/10 - Malattie Dell'Apparato Respiratorio, chronic lung disease, Pulmonary Disease, 03 medical and health sciences, Bronchiectasi, Internal medicine, Pseudomonas, controlled study, human, Cross-Sectional Studie, business.industry, Risk Factor, community acquired pneumonia, Pneumonia, medicine.disease, logistic regression analysis, major clinical study, antibiotic sensitivity, hospital admission, 030228 respiratory system, microbiological examination, business, chronic obstructive lung disease
Abstract

Pseudomonas aeruginosa is a challenging bacterium to treat due to its intrinsic resistance to the antibiotics used most frequently in patients with community-acquired pneumonia (CAP). Data about the global burden and risk factors associated with P. aeruginosa-CAP are limited. We assessed the multinational burden and specific risk factors associated with P. aeruginosa-CAP. We enrolled 3193 patients in 54 countries with confirmed diagnosis of CAP who underwent microbiological testing at admission. Prevalence was calculated according to the identification of P. aeruginosa. Logistic regression analysis was used to identify risk factors for antibiotic-susceptible and antibiotic-resistant P. aeruginosa-CAP. The prevalence of P. aeruginosa and antibiotic-resistant P. aeruginosa-CAP was 4.2% and 2.0%, respectively. The rate of P. aeruginosa CAP in patients with prior infection/colonisation due to P. aeruginosa and at least one of the three independently associated chronic lung diseases (i.e. tracheostomy, bronchiectasis and/or very severe chronic obstructive pulmonary disease) was 67%. In contrast, the rate of P. aeruginosa-CAP was 2% in patients without prior P. aeruginosa infection/colonisation and none of the selected chronic lung diseases. The multinational prevalence of P. aeruginosa-CAP is low. The risk factors identified in this study may guide healthcare professionals in deciding empirical antibiotic coverage for CAP patients.

Published
2018
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6. The respiratory threat posed by multidrug resistant Gram-negative bacteria

Author

Ana Rodrigo-Troyano and Oriol Sibila

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Bronchiectasis, Respiratory tract infections, biology, business.industry, Pseudomonas aeruginosa, medicine.drug_class, Antibiotics, medicine.disease, medicine.disease_cause, biology.organism_classification, Acinetobacter baumannii, Multiple drug resistance, 03 medical and health sciences, Pneumonia, 0302 clinical medicine, Antibiotic resistance, 030228 respiratory system, Medicine, 030212 general & internal medicine, business, Intensive care medicine
Abstract

Respiratory infections are a major cause of global mortality and morbidity. In recent years, an increased incidence of multidrug-resistant (MDR) Gram-negative bacteria (GNB) has been described. Microorganisms such as Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae or Acinetobacter baumannii have been identified as causative pathogens of different respiratory tract infections. Several studies have detected MDR-GNB in patients with community-acquired and nosocomial pneumonia. Furthermore, MDR-GNB have also been isolated in patients with chronic obstructive pulmonary disease and bronchiectasis having acute or chronic bronchial infection. Prevalence varies depending on the geographical area but MDR-GNB has been reported in the Asia-Pacific region, Europe and the United States, reaching rates of 70% in hospital-acquired infection. The presence of MDR-GNB has been related to poor clinical outcomes, including increased mortality, although data regarding this relationship are limited. This is probably linked to inappropriate selection of empiric antibiotic treatment; this poses a threat of widespread resistance. GNB antibiotic resistance and the absence of new antibiotics are a major concern given limited treatment options; an aspect that deserves future research. We review current literature, highlight prevalence of MDR-GNB in different respiratory infections and explore their impact on clinical outcomes.

Published
2017
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7. Bacterial etiology of community-acquired pneumonia in immunocompetent hospitalized patients and appropriateness of empirical treatment recommendations: an international point-prevalence study

Author

Carugati, Manuela, Aliberti, S., Sotgiu, G., Blasi, F., Gori, A., Menendez, R., Encheva, M., Gallego, M., Leuschner, P., Ruiz-Buitrago, S., Battaglia, S., Fantini, R., Pascual-Guardia, S., Marin-Corral, J., Restrepo, M. I., Aruj, Patricia Karina, Attorri, Silvia, Barimboim, Enrique, Caeiro, Juan Pablo, Garzón, María I, Cambursano, Victor Hugo, Ceccato, Adrian, Chertcoff, Julio, Lascar, Florencia, Tulio, Fernando Di, Díaz, Ariel Cordon, de Vedia, Lautaro, Ganaha, Maria Cristina, Lambert, Sandra, Lopardo, Gustavo, Luna, Carlos M, Malberti, Alessio Gerardo, Morcillo, Nora, Tartara, Silvina, Pensotti, Claudia, Pereyra, Betiana, Scapellato, Pablo Gustavo, Stagnaro, Juan Pablo, Shah, Sonali, Lötsch, Felix, Thalhammer, Florian, Vincent, Jean Louis, Anseeuw, Kurt, Francois, Camille A, Van Braeckel, Eva, Djimon, Marcel Zannou, Bashi, Jules, Roger, Dodo, Nouér, Simone Aranha, Chipev, Peter, Encheva, Milena, Miteva, Darina, Petkova, Diana, Dodo, Balkissou Adamou, Ngahane, Mbatchou, Hugo, Bertrand, Shen, Ning, Xu, Jin-fu, Rico, Carlos Andres Bustamante, Buitrago, Ricardo, Paternina, Fernando Jose Pereira, Jean-Marie, Kayembe Ntumba, Carevic, Vesna Vladic, Jakopovic, Marko, Jankovic, Mateja, Matkovic, Zinka, Mitrecic, Ivan, Jacobsson, Marie-Laure Bouchy, Christensen, Anette Bro, HeitmannBødtger, Uff e Christian, Meyer, Christian Niels, Jensen, Andreas Vestergaard, Baunbæk-knudsen, Gertrud, Petersen, Pelle Trier, Andersen, Stine, El-Wahhab, Ibrahim El-Said Abd, Morsy, Nesreen Elsayed, Shafiek, Hanaa, Sobh, Eman, Bertrand, Fabrice, Brun-Buisson, Christian, de Montmollin, Etienne, Fartoukh, Muriel, Messika, Jonathan, Tattevin, Pierre, Dreher, Michael, Kolditz, Martin, Meisinger, Matthias, Pletz, Mathias W, Hagel, Stefan, Rupp, Jan, Schaberg, Tom, Spielmanns, Marc, Siaw-Lartey, Beatrice, Dimakou, Katerina, Papapetrou, Dimosthenis, Tsigou, Evdoxia, Ampazis, Dimitrios, Bhatia, Mohit, Dhar, Raja, D’Souza, George, Garg, Rajiv, Koul, Parvaiz A, Mahesh, P A, Jayaraj, B S, Narayan, Kiran Vishnu, Udnur, Hirennappa B, Krishnamurthy, Shashi Bhaskara, Golshani, Keihan, Keatings, Vera M, Martin-Loeches, Ignacio, Maor, Yasmin, Strahilevitz, Jacob, Battaglia, Salvatore, Carrabba, Maria, Ceriana, Piero, Confalonieri, Marco, d’Arminio Monforte, Antonella, Del Prato, Bruno, De Rosa, Marino, Fantini, Riccardo, Fiorentino, Giuseppe, Gammino, Maria Antonia, Menzella, Francesco, Milani, Giuseppe, Nava, Stefano, Palmiero, Gerardo, Petrino, Roberta, Gabrielli, Barbra, Rossi, Paolo, Sorino, Claudio, Steinhilber, Gundi, Zanforlin, Alessandro, Kurahashi, Kiyoyasu, Bacha, Zeina Aoun, Ugalde, Daniel Barajas, Zuñiga, Omar Ceballos, Villegas, José F, Medenica, Milic, van de Garde, E M W, Mihsra, Deebya Raj, Shrestha, Poojan, Ridgeon, Elliott, Awokola, Babatunde Ishola, Nwankwo, Ogonna N O, Olufunlola, Adefuye Bolanle, Olumide, Segaolu, Ukwaja, Kingsley N, Irfan, Muhammad, Minarowski, Lukasz, Szymon, Skoczyński, Froes, Felipe, Leuschner, Pedro, Meireles, Mariana, Ferrão, Cláudia, Neves, João, Ravara, Sofia B, da Beira, Cova, Brocovschii, Victoria, Ion, Chesov, Rusu, Doina, Toma, Cristina, Chirita, Daniela, Birkun, Alexei, Kaluzhenina, Anna, Almotairi, Abdullah, Abdulbaqi, Zakeya, Bukhary, Ali, Edathodu, Jameela, Fathy, Amal, Enani, Abdullah Mushira Abdulaziz, Mohamed, Nazik Eltayeb, Memon, Jawed Ulhadi, Bogdanović, Nada, Milenkovic, Branislava, Pesut, Dragica, Borderìas, Luis, Garcia, Noel Manuel Bordon, Alarcón, Hugo Cabello, Cilloniz, Catia, Torres, Antoni, Diaz-Brito, Vicens, Casas, Xavier, González, Alicia Encabo, Fernández-Almira, Maria Luisa, Gallego, Miguel, Gaspar-GarcÍa, Inmaculada, del Castillo, Juan González, Victoria, Patricia Javaloyes, Martínez, Elena Laserna, de Molina, Rosa Malo, Marcos, Pedro J, Menéndez, Rosario, PandoSandova, Ana, Aymerich, Cristina Prat, del la Torre, Alicia Lacoma, García-Olivé, Ignasi, Rello, Jordi, Moyano, Silvia, Sanz, Francisco, Sibila, Oriol, Rodrigo-Troyano, Ana, Solé-Violán, Jordi, Uranga, Ane, van Boven, Job FM, Torra, Ester Vendrell, Pujol, Jordi Almirall, Feldman, Charles, Yum, Ho Kee, Fiogbe, Arnauld Attannon, Yangui, Ferdaous, Bilaceroglu, Semra, Dalar, Levent, Yilmaz, Ufuk, Bogomolov, Artemii, Elahi, Naheed, Dhasmana, Devesh J, Ions, Rhiannon, Skeemer, Julie, Woltmann, Gerrit, Hancock, Carole, Hill, Adam T, Rudran, Banu, Ruiz-Buitrago, Silvia, Campbell, Marion, Whitaker, Paul, Allen, Karen S, Brito, Veronica, Dietz, Jessica, Dysart, Claire E, Kellie, Susan M, Franco-Sadud, Ricardo A, Meier, Garnet, Gaga, Mina, Holland, Thomas L, Bergin, Stephen P, Kheir, Fayez, Landmeier, Mark, Lois, Manuel, Nair, Girish B, Patel, Hemali, Reyes, Katherine, Rodriguez-Cintron, William, Saito, Shigeki, Soni, Nilam J, Noda, Julio, Hinojosa, Cecilia I, Levine, Stephanie M, Angel, Luis F, Anzueto, Antonio, Whitlow, K Scott, Hipskind, John, Sukhija, Kunal, Wunderink, Richard G., Shah, Ray D, Mateyo, Kondwelani John, Carugati, Manuela, Aliberti, S, Sotgiu, G, Blasi, F, Gori, A, Menendez, R, Encheva, M, Gallego, M, Leuschner, P, Ruiz-Buitrago, S, Battaglia, S, Fantini, R, Pascual-Guardia, S, Marin-Corral, J, and Restrepo, M I

Subjects
Male, 0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Community-acquired pneumonia, 030106 microbiology, Antimicrobial treatment, Prevalence, Guideline, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Guidelines, Global Health, medicine.disease_cause, Immunocompromised Host, 03 medical and health sciences, 0302 clinical medicine, Medical microbiology, Internal medicine, Epidemiology, Streptococcus pneumoniae, Pneumonia, Bacterial, Humans, Medicine, 030212 general & internal medicine, Practice Patterns, Physicians', Aged, Aged, 80 and over, business.industry, Correction, General Medicine, Middle Aged, medicine.disease, Anti-Bacterial Agents, Community-Acquired Infections, Hospitalization, Pneumonia, Infectious Diseases, Practice Guidelines as Topic, Pseudomonas aeruginosa, Etiology, Original Article, Female, Guideline Adherence, business
Abstract

An accurate knowledge of the epidemiology of community-acquired pneumonia (CAP) is key for selecting appropriate antimicrobial treatments. Very few etiological studies assessed the appropriateness of empiric guideline recommendations at a multinational level. This study aims at the following: (i) describing the bacterial etiologic distribution of CAP and (ii) assessing the appropriateness of the empirical treatment recommendations by clinical practice guidelines (CPGs) for CAP in light of the bacterial pathogens diagnosed as causative agents of CAP. Secondary analysis of the GLIMP, a point-prevalence international study which enrolled adults hospitalized with CAP in 2015. The analysis was limited to immunocompetent patients tested for bacterial CAP agents within 24 h of admission. The CAP CPGs evaluated included the following: the 2007 and 2019 American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA), the European Respiratory Society (ERS), and selected country-specific CPGs. Among 2564 patients enrolled, 35.3% had an identifiable pathogen. Streptococcus pneumoniae (8.2%) was the most frequently identified pathogen, followed by Pseudomonas aeruginosa (4.1%) and Klebsiella pneumoniae (3.4%). CPGs appropriately recommend covering more than 90% of all the potential pathogens causing CAP, with the exception of patients enrolled from Germany, Pakistan, and Croatia. The 2019 ATS/IDSA CPGs appropriately recommend covering 93.6% of the cases compared with 90.3% of the ERS CPGs (p

Published
2020

8. Pseudomonas aeruginosa en la enfermedad pulmonar obstructiva crónica; papel de los patrones de resistencia e impacto en las agudizaciones graves

Author

Rodrigo Troyano, Ana Maria, Sibila Vidal, Oriol, Plaza Moral, Vicente, and Universitat Autònoma de Barcelona. Departament de Medicina

Subjects
Agudización, Pseudomonas aeruginosa, MPOC, COPD, Agudització, 616.2, Exacerbation, EPOC, Ciències de la Salut
Abstract

La enfermedad pulmonar obstructiva crónica (EPOC) es una enfermedad prevalente que genera un gran impacto social y sanitario. Las agudizaciones de la enfermedad son la causa más importante de admisión hospitalaria, gasto sanitario y mortalidad, siendo las infecciones bronquiales la causa más frecuente de agudización. La infección por P. aeruginosa se ha asociado a peores resultados clínicos en diferentes enfermedades respiratorias. En la EPOC, se aísla de forma frecuente en las agudizaciones graves que requieren de ingreso hospitalario. Además en los últimos años se ha apreciado un aumento en el patrón de resistencias a los antibióticos más utilizados. Sin embargo, el impacto de la infección bronquial por P.aeruginosa y sus patrones de resistencia en pacientes con EPOC y agudizaciones frecuentes no está bien establecido. La hipótesis que nos planteamos es que los pacientes con EPOC y agudizaciones graves por P. aeruginosa tienen peores resultados clínicos, presentando una mayor tasa de readmisión hospitalaria y que el patrón de resistencia microbiológica tiene un impacto en el pronóstico. Es por ello que el objetivo de esta tesis es evaluar el impacto de P. aeruginosa y su patrón de resistencias en las agudizaciones de EPOC que requieren de ingreso hospitalario. Con esta premisa se diseñaron dos estudios prospectivos en los que se incluyeron pacientes con agudizaciones graves de EPOC. En el primer estudio se incluyeron solo los pacientes con EPOC y cultivo de esputo positivo al ingreso para P. aeruginosa y se evaluaron resultados clínicos en función del patrón de resistencia. Este estudio concluye que los pacientes EPOC ingresados por una agudización con aislamiento de P. aeruginosa en el cultivo de esputo tienen diferentes resultados en función del patrón de resistencia a antibióticos. Los pacientes con P. aeruginosa multisensible presentaban mayor mortalidad comparados con los que tenían un patrón de resistencia a antibióticos, y permanecían en la vía aérea a pesar de recibir un correcto tratamiento antibiótico, sugiriendo distintas formas de virulencia en función del patrón de resistencias. En el segundo estudio se reclutaron pacientes con agudización grave de EPOC independientemente del aislamiento microbiológico. Posteriormente se evaluaron prevalencia, factores de riesgo e impacto en resultados, del grupo de pacientes con aislamiento de P.aeruginosa al compararlo con aquellos en los que no se aislaban MPP. Este estudio concluye que el aislamiento de P. aeruginosa juega un papel importante en la evolución de los pacientes con EPOC, aumentando el porcentaje de readmisiones por agudización y persistiendo en el esputo durante el seguimiento. La conclusión global de este trabajo es que las agudizaciones graves de EPOC debidas a P.aeruginosa presentan peores resultados clínicos, asociándose a un mayor número de readmisiones hospitalarias y se han observado diferencias en la evolución clínica de los pacientes en función del patrón de resistencia antibiótica. Chronic obstructive pulmonary disease (COPD) is a prevalent disease that generates a great social and health impact. The exacerbations of the disease are the most important cause of hospital admission, health expenditure and mortality, with bronchial infections being the most frequent cause of exacerbation. P. aeruginosa infection has been associated with poorer clinical outcomes in different respiratory diseases. In COPD, it is frequently isolated in severe exacerbations that require hospital admission. In addition, in recent years there has been an increase in the pattern of resistance to the most commonly used antibiotics. However, the impact of bronchial infection due to P. aeruginosa and its resistance patterns in patients with COPD and frequent exacerbations is not well established. The hypothesis that we propose is that patients with COPD and exacerbations due to P. aeruginosa have poorer clinical results, presenting a greater hospital readmission and that the pattern of microbiological resistance has an impact on outcomes. That is why the objective of this thesis is to evaluate the impact of P. aeruginosa and its pattern of resistance in exacerbations of COPD who required hospital admission. In accordance with this premise, two prospective studies were designed in which patients with severe exacerbations of COPD. In the first study, only patients with COPD and positive sputum culture at admission for P. aeruginosa were included and clinical results were evaluated according to the resistance pattern. The first study concludes that COPD patients admitted for an exacerbation with isolation of P. aeruginosa in sputum culture have different results depending on the pattern of resistance to antibiotics. Patients with multisensible P. aeruginosa had higher mortality compared to those who had a pattern of resistance to antibiotics, who stayed in the airway despite receiving a correct antibiotic treatment, suggesting different forms of virulence depending on the pattern of resistance. In the second study, patients with severe exacerbation and COPD were enrolled regardless of microbiological isolation. Subsequently, prevalence, risk factors and impact on the results of the group of patients with P. aeruginosa isolation were evaluated when compared to those in which MPP was not isolated. This work concludes that the isolation of P. aeruginosa plays an important role in the evolution of patients with COPD, increasing the percentage of readmissions due to exacerbation and persisting in the sputum during follow-up. The overall conclusion of this study is that severe exacerbations of COPD due to P.aeruginosa present worse clinical results, being associated with a greater number of hospital readmissions and differences in the clinical evolution of patients have been observed depending on the pattern of antibiotic resistance.

Published
2019

9. Secreted mucins and airway bacterial colonization in non-CF bronchiectasis

Author

Ferran Sanchez-Reus, Marcos I. Restrepo, Diego Castillo, Ana Rodrigo-Troyano, Simon Finch, Guillermo Suarez-Cuartin, Eder Mateus, Oriol Sibila, James D. Chalmers, Laia Garcia-Bellmunt, Thomas C. Fardon, and Silvia Vidal

Subjects
Pulmonary and Respiratory Medicine, Microbiological culture, Bronchiectasis, business.industry, Pseudomonas aeruginosa, Mucin, respiratory system, medicine.disease_cause, medicine.disease, digestive system diseases, respiratory tract diseases, Haemophilus influenzae, Microbiology, Pathogenesis, Immunology, medicine, Sputum, medicine.symptom, business, Airway
Abstract

Background and objective Secreted mucins play a key role in antibacterial defence in the airway, but have not previously been characterized in non-cystic fibrosis (CF) bronchiectasis patients. We aim to investigate the relationship between secreted mucins levels and the presence of bacterial colonization due to potentially pathogenic microorganisms (PPM) in the airways of stable bronchiectasis patients. Methods Clinically stable bronchiectasis patients were studied prospectively at two centres. Patients with other pulmonary conditions were excluded. Spontaneous sputum was subject to bacterial culture, and secreted mucins (MUC2, MUC5AC and MUC5B) were measured in sputum supernatants by ELISA. Results A total of 50 patients were included. PPM were identified from sputum samples in 30 (60%), with Pseudomonas aeruginosa (n = 10) and Haemophilus influenzae (n = 10) as the most common PPM. There were no baseline differences among airway colonized and non-colonized patients. Patients with airways colonized by PPM presented higher levels of airway MUC2. No differences in MUC5AC levels were found among groups, whereas MUC5B levels were undetectable. Patients with P. aeruginosa colonization expressed the highest levels of MUC2. High levels of MUC2 and MUC5AC are also correlated with disease severity using the Bronchiectasis Severity Index. Conclusions Airway MUC2 levels were higher in bronchiectasis patients colonized with PPM compared with those without airway colonization, especially in patients with P. aeruginosa. These findings suggest that airway-secreted mucins levels may play a role in the pathogenesis of airway infection in non-CF bronchiectasis.

Published
2015
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10. Anti-Pseudomonas aeruginosa IgG antibodies and chronic airway infection in bronchiectasis

Author

Suarez-Cuartin G., Smith A., Abo-Leyah H., Rodrigo-Troyano A., Perea L., Vidal S., Plaza V., Fardon T.C., Sibila O., and Chalmers J.D.

Subjects
Male, Cystic Fibrosis, bronchiectasis, respiratory tract infection, Vital Capacity, sputum analysis, Severity of Illness Index, Article, Antibodies, immunology, bacterium antibody, blood, antibody, Forced Expiratory Volume, chronic airway infection, middle aged, follow up, Humans, Pseudomonas Infections, immunoglobulin G antibody, human, immunoassay, Prospective Studies, Respiratory Tract Infections, pathophysiology, isolation and purification, adult, microbiology, Sputum, major clinical study, United Kingdom, enzyme linked immunosorbent assay, aged, female, priority journal, sensitivity and specificity, disease exacerbation, physiology, Pseudomonas aeruginosa, Disease Progression, epidemiology, Pseudomonas infection, prospective study
Abstract

Background Identification of chronic Pseudomonas aeruginosa (PA) infection is important in the management of bronchiectasis, but requires repeated sputum sampling. We hypothesized that serum anti-PA IgG antibodies could diagnose chronic PA infection at a single visit. Methods Clinically stable bronchiectasis patients were studied prospectively. Chronic PA infection was defined as 2 or more positive sputum samples at least 3 months apart and/or failure to clear PA following eradication treatment. Baseline serum anti-PA IgG was determined by a validated ELISA kit. Results A total of 408 patients were included. Sixty of them (14.7%) had chronic PA infection and had higher anti-PA IgG levels (median 6.2 vs. 1.3 units, p

Published
2017

11. Anti-Pseudomonas aeruginosa IgG antibodies and chronic airway infection in bronchiectasis

Author

Thomas C. Fardon, Silvia Vidal, A. Smith, Hani Abo-Leyah, Guillermo Suarez-Cuartin, Vicente Plaza, Lidia Perea, Ana Rodrigo-Troyano, James D. Chalmers, and Oriol Sibila

Subjects
Pulmonary and Respiratory Medicine, Male, Cystic Fibrosis, Vital Capacity, medicine.disease_cause, Cystic fibrosis, Severity of Illness Index, Antibodies, 03 medical and health sciences, 0302 clinical medicine, Forced Expiratory Volume, Severity of illness, medicine, Humans, Pseudomonas Infections, 030212 general & internal medicine, Prospective Studies, Respiratory Tract Infections, Aged, Bronchiectasis, biology, Respiratory tract infections, Pseudomonas aeruginosa, business.industry, Sputum, Middle Aged, medicine.disease, United Kingdom, Chronic infection, 030228 respiratory system, Immunology, biology.protein, Disease Progression, Female, medicine.symptom, Antibody, business
Abstract

Identification of chronic Pseudomonas aeruginosa (PA) infection is important in the management of bronchiectasis, but requires repeated sputum sampling. We hypothesized that serum anti-PA IgG antibodies could diagnose chronic PA infection at a single visit.Clinically stable bronchiectasis patients were studied prospectively. Chronic PA infection was defined as 2 or more positive sputum samples at least 3 months apart and/or failure to clear PA following eradication treatment. Baseline serum anti-PA IgG was determined by a validated ELISA kit.A total of 408 patients were included. Sixty of them (14.7%) had chronic PA infection and had higher anti-PA IgG levels (median 6.2 vs. 1.3 units, p 0.001). Antibody levels showed direct significant correlations with exacerbation frequency, the bronchiectasis severity index and sputum inflammatory markers. Fifty-seven patients with chronic PA infection had a positive test, giving 95% sensitivity, 74.4% specificity and AUROC of 0.87. During follow-up, 38 patients had a new PA isolation. Eradication at 12 months was achieved in 89.5% of subjects with a negative antibody test and 15.8% of patients with a positive test.Anti-PA IgG test is highly accurate to detect chronic PA infection in bronchiectasis patients. In addition, it may be a marker of disease severity and treatment response.

Published
2016

12. Anti-Pseudomonas aeruginosa IgG Antibodies and Chronic Airway Infection in Non-Cystic Fibrosis Bronchiectasis

Author

Ana Rodrigo-Troyano, Thomas C. Fardon, S Vidal, A Smith, Guillermo Suarez-Cuartin, James D. Chalmers, H Abo-Leyah, Oriol Sibila, and Vicente Plaza

Subjects
Pulmonary and Respiratory Medicine, biology, Pseudomonas aeruginosa, business.industry, Non cystic fibrosis bronchiectasis, Immunology, medicine, biology.protein, Antibody, medicine.disease_cause, business, Airway
Published
2016
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13. Pseudomonas aeruginosa resistance patterns and clinical outcomes in hospitalized exacerbations of COPD

Author

Rodrigo-Troyano, A, Suarez-Cuartin, G, Peiro, M, Barril, S, Castillo, D, Sanchez-Reus, F, Plaza, V, Restrepo, MI, Chalmers, JD, and Sibila, O

Subjects
exacerbation, Pseudomonas aeruginosa, COPD
Abstract

Background and objectiveAcute exacerbations of chronic obstructive pulmonary disease (AECOPD) due to Pseudomonas aeruginosa (PA) are associated with worse outcomes. PA antibiotic resistance is important to determine treatment and may influence clinical outcomes. The aim was to study clinical characteristics and outcomes in patients with AECOPD associated with PA based on their antibiotic resistance. MethodsThis was a prospective observational study including all patients with AECOPD and positive PA sputum culture admitted in a respiratory ward in a tertiary hospital in Barcelona during 2013-2014. PA was defined as resistant (PA-R) when the antibiogram showed 1 resistance. ResultsFour hundred one patients with AECOPD were evaluated. Of them, 54 (13%) had a positive PA sputum culture. Eighty-two per cent were men, median age was 77 (SD 7) years old and FEV1 was less than 36% (SD 17) of predicted value. PA-R was isolated in 35 patients (66%), and PA-sensitive (PA-S) was isolated in 18 (34%) patients. No differences were found in demographics, lung function and comorbidities among groups. PA-R patients were more likely exposed to prior oral corticosteroids (77% vs 44%, P=0.03) and antibiotics (77% vs 31%, P=0.01), respectively. AECOPD patients associated with PA-S were more likely to die at 30 days (odds ratio 13.53, 95% confidence interval: 1.14-69.56, P=0.03) and 90 days (odds ratio 7.09, 95% confidence interval: 1.33-37.89, P=0.02), respectively. ConclusionPseudomonas aeruginosa-resistant affects patients with severe AECOPD and previous use of corticosteroids and antibiotics. The presence of PA-S is associated with higher mortality. These results may suggest increased virulence in PA-S strains causing acute infections. Pseudomonas aeruginosa (PA) plays an important role in AECOPD. However, the impact of PA resistance patterns on clinical outcomes is not clear. Our study demonstrates that the presence of PA-sensitive is associated with higher mortality.

Published
2016

14. Pseudomonas aeruginosa resistance patterns and clinical outcomes in hospitalized exacerbations of COPD

Author

Ana, Rodrigo-Troyano, Guillermo, Suarez-Cuartin, Meritxell, Peiró, Silvia, Barril, Diego, Castillo, Ferran, Sanchez-Reus, Vicente, Plaza, Marcos I, Restrepo, James D, Chalmers, and Oriol, Sibila

Subjects
Aged, 80 and over, Male, Sputum, Drug Resistance, Microbial, Symptom Flare Up, Anti-Bacterial Agents, Hospitalization, Pulmonary Disease, Chronic Obstructive, Risk Factors, Spain, Pseudomonas aeruginosa, Odds Ratio, Humans, Female, Prospective Studies, Aged
Abstract

Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) due to Pseudomonas aeruginosa (PA) are associated with worse outcomes. PA antibiotic resistance is important to determine treatment and may influence clinical outcomes. The aim was to study clinical characteristics and outcomes in patients with AECOPD associated with PA based on their antibiotic resistance.This was a prospective observational study including all patients with AECOPD and positive PA sputum culture admitted in a respiratory ward in a tertiary hospital in Barcelona during 2013-2014. PA was defined as resistant (PA-R) when the antibiogram showed ≥1 resistance.Four hundred one patients with AECOPD were evaluated. Of them, 54 (13%) had a positive PA sputum culture. Eighty-two per cent were men, median age was 77 (SD 7) years old and FEV1 was less than 36% (SD 17) of predicted value. PA-R was isolated in 35 patients (66%), and PA-sensitive (PA-S) was isolated in 18 (34%) patients. No differences were found in demographics, lung function and comorbidities among groups. PA-R patients were more likely exposed to prior oral corticosteroids (77% vs 44%, P = 0.03) and antibiotics (77% vs 31%, P = 0.01), respectively. AECOPD patients associated with PA-S were more likely to die at 30 days (odds ratio 13.53, 95% confidence interval: 1.14-69.56, P = 0.03) and 90 days (odds ratio 7.09, 95% confidence interval: 1.33-37.89, P = 0.02), respectively.Pseudomonas aeruginosa-resistant affects patients with severe AECOPD and previous use of corticosteroids and antibiotics. The presence of PA-S is associated with higher mortality. These results may suggest increased virulence in PA-S strains causing acute infections.

Published
2015

15. Acute exacerbations of COPD due topseudomonas aeruginosa: Impact of antimicrobial resistance

Author

Vicente Plaza, Guillermo Suarez-Cuartin, Meritxell Peiro, James D. Chalmers, Oriol Sibila, Ingrid Solanes, Diego Castillo, Ferran Sanchez-Reus, Ana Rodrigo-Troyano, and Marcos I. Restrepo

Subjects
medicine.medical_specialty, COPD, medicine.diagnostic_test, Pseudomonas aeruginosa, medicine.drug_class, business.industry, Antibiotics, medicine.disease_cause, medicine.disease, Sputum culture, Persistence (computer science), Surgery, Antibiotic resistance, Internal medicine, medicine, Sputum, medicine.symptom, Respiratory system, business
Abstract

Introduction: Acute Exacerbations of Chronic Obstructive Pulmonary disease (AECOPD) due to Pseudomonas aeruginosa (PA) are associated with worse outcomes. PA antibiotic resistance is important to determine treatment. Objectives: To study clinical characteristics and outcomes in patients with AECOPD due to PA based on their antibiotic resistance. Methods: Prospective observational study including all patients with AECOPD due to PA admitted in a Respiratory ward in a tertiary hospital in Barcelona during 2013-2014. Resistant PA (PA-R) was defined when ≥1 class of antibiotics were resistant on the antibiogram. Results: 401 patients with AECOPD were evaluated. Of them, 53 (13%) had a positive PA sputum culture. 82% were men, median age (± SD) 77 (±7) years old and FEV1 36 (±17) % of predicted. PA-R was isolated in 35 patients (66%).No differences in demographics, lung function and comorbidities among patients with PA-R and PA-sensible (PA-S) were found, except that patients with PA-R had received more prior oral steroids (80% vs 44%, p = 0.009) and antibiotics (65% vs 33%, p = 0.02) PA persistence after adequate treatment was higher in the PA-R group (82% vs 50%, p = 0.04). However, patients with PA-R had lower 30-day and 90-day mortality when compared to patients with PA –S (3% vs 22%, p = 0.02, and 9% vs 33%, p= 0.02, respectively). Conclusions: PA-R affects patients with severe COPD and previous use of steroids and antibiotics. Persistent PA-R strains were found in follow-up sputum samples. However, the presence of sensitive PA is associated with higher mortality. These results may reflect a contrast between acute infections caused by PA-S and chronic colonization with PA-R.

Published
2015
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16. Antimicrobial peptides, disease severity and exacerbations in bronchiectasis.

Author

Sibila, Oriol, Perea, Lídia, Cantó, Elisabet, Shoemark, Amelia, Cassidy, Diane, Smith, Alexandria Holly, Suarez-Cuartin, Guillermo, Rodrigo-Troyano, Ana, Keir, Holly R., Oriano, Martina, Ong, Samantha, Vidal, Silvia, Blasi, Francesco, Aliberti, Stefano, and Chalmers, James D.

Subjects
BRONCHIECTASIS, PSEUDOMONAS aeruginosa infections, DISEASE exacerbation, ANTIMICROBIAL peptides, LACTOFERRIN
Abstract

Rationale: Recently a frequent exacerbator phenotype has been described in bronchiectasis, but the underlying biological mechanisms are unknown. Antimicrobial peptides (AMPs) are important in host defence against microbes but can be proinflammatory in chronic lung disease.Objectives: To determine pulmonary and systemic levels of AMP and their relationship with disease severity and future risk of exacerbations in bronchiectasis.Methods: A total of 135 adults with bronchiectasis were prospectively enrolled at three European centres. Levels of cathelicidin LL-37, lactoferrin, lysozyme and secretory leucocyte protease inhibitor (SLPI) in serum and sputum were determined at baseline by ELISA. Patients were followed up for 12 months. We examined the ability of sputum AMP to predict future exacerbation risk.Measurements and Main Results: AMP levels were higher in sputum than in serum, suggesting local AMP release. Patients with more severe disease at baseline had dysregulation of airway AMP. Higher LL-37 and lower SLPI levels were associated with Bronchiectasis Severity Index, lower FEV1 (forced expiratory volume in 1 s) and Pseudomonas aeruginosa infection. Low SLPI levels were also associated with the exacerbation frequency at baseline. During follow-up, higher LL-37 and lower SLPI levels were associated with a shorter time to the next exacerbation, whereas LL-37 alone predicted exacerbation frequency over the next 12 months.Conclusions: Patients with bronchiectasis showed dysregulated sputum AMP levels, characterised by elevated LL-37 and reduced SLPI levels in the frequent exacerbator phenotype. Elevated LL-37 and reduced SLPI levels are associated with Pseudomonas aeruginosa infection and can predict future risk of exacerbations in bronchiectasis. [ABSTRACT FROM AUTHOR]

Published
2019
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17. Secreted mucins and airway bacterial colonization in non-CF bronchiectasis

Author

Oriol, Sibila, Guillermo, Suarez-Cuartin, Ana, Rodrigo-Troyano, Thomas C, Fardon, Simon, Finch, Eder Freddy, Mateus, Laia, Garcia-Bellmunt, Diego, Castillo, Silvia, Vidal, Ferran, Sanchez-Reus, Marcos I, Restrepo, and James D, Chalmers

Subjects
Male, Respiratory System, Statistics as Topic, Colony Count, Microbial, Mucins, Sputum, Middle Aged, Haemophilus influenzae, Severity of Illness Index, Bronchiectasis, Cross-Sectional Studies, Pseudomonas aeruginosa, Humans, Female, Prospective Studies, Aged
Abstract

Secreted mucins play a key role in antibacterial defence in the airway, but have not previously been characterized in non-cystic fibrosis (CF) bronchiectasis patients. We aim to investigate the relationship between secreted mucins levels and the presence of bacterial colonization due to potentially pathogenic microorganisms (PPM) in the airways of stable bronchiectasis patients.Clinically stable bronchiectasis patients were studied prospectively at two centres. Patients with other pulmonary conditions were excluded. Spontaneous sputum was subject to bacterial culture, and secreted mucins (MUC2, MUC5AC and MUC5B) were measured in sputum supernatants by ELISA.A total of 50 patients were included. PPM were identified from sputum samples in 30 (60%), with Pseudomonas aeruginosa (n = 10) and Haemophilus influenzae (n = 10) as the most common PPM. There were no baseline differences among airway colonized and non-colonized patients. Patients with airways colonized by PPM presented higher levels of airway MUC2. No differences in MUC5AC levels were found among groups, whereas MUC5B levels were undetectable. Patients with P. aeruginosa colonization expressed the highest levels of MUC2. High levels of MUC2 and MUC5AC are also correlated with disease severity using the Bronchiectasis Severity Index.Airway MUC2 levels were higher in bronchiectasis patients colonized with PPM compared with those without airway colonization, especially in patients with P. aeruginosa. These findings suggest that airway-secreted mucins levels may play a role in the pathogenesis of airway infection in non-CF bronchiectasis.

Published
2014

18. Secreted mucins and airway bacterial colonization in non- CF bronchiectasis.

Author

Sibila, Oriol, Suarez‐Cuartin, Guillermo, Rodrigo‐Troyano, Ana, Fardon, Thomas C., Finch, Simon, Mateus, Eder Freddy, Garcia‐Bellmunt, Laia, Castillo, Diego, Vidal, Silvia, Sanchez‐Reus, Ferran, Restrepo, Marcos I., and Chalmers, James D.

Subjects
MUCINS, MUCOPROTEINS, BRONCHIECTASIS, BRONCHIAL diseases, PSEUDOMONAS aeruginosa
Abstract

Background and objective Secreted mucins play a key role in antibacterial defence in the airway, but have not previously been characterized in non-cystic fibrosis (CF) bronchiectasis patients. We aim to investigate the relationship between secreted mucins levels and the presence of bacterial colonization due to potentially pathogenic microorganisms ( PPM) in the airways of stable bronchiectasis patients. Methods Clinically stable bronchiectasis patients were studied prospectively at two centres. Patients with other pulmonary conditions were excluded. Spontaneous sputum was subject to bacterial culture, and secreted mucins ( MUC2, MUC5AC and MUC5B) were measured in sputum supernatants by ELISA. Results A total of 50 patients were included. PPM were identified from sputum samples in 30 (60%), with P seudomonas aeruginosa ( n = 10) and H aemophilus influenzae ( n = 10) as the most common PPM. There were no baseline differences among airway colonized and non-colonized patients. Patients with airways colonized by PPM presented higher levels of airway MUC2. No differences in MUC5AC levels were found among groups, whereas MUC5B levels were undetectable. Patients with P . aeruginosa colonization expressed the highest levels of MUC2. High levels of MUC2 and MUC5AC are also correlated with disease severity using the Bronchiectasis Severity Index. Conclusions Airway MUC2 levels were higher in bronchiectasis patients colonized with PPM compared with those without airway colonization, especially in patients with P . aeruginosa. These findings suggest that airway-secreted mucins levels may play a role in the pathogenesis of airway infection in non-CF bronchiectasis. [ABSTRACT FROM AUTHOR]

Published
2015
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