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1 From the University Department of Microbiology, Queen Mary Hospital, The University of Hong Kong, Pokfulam Road, Hong Kong
2 From the University Department of Paediatrics, Queen Mary Hospital, The University of Hong Kong, Pokfulam Road, Hong Kong
3 From the University Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam Road, Hong Kong
KWT Tsang, MD (with Honors), MRCP (UK), FCCP, University Department of Medicine, Queen Mary Hospital, Pokfulam Road, Hong Kong
Study objective: To investigate the effect of Pseudomonas aeruginosa infection on clinical parameters in Chinese patients with noncystic fibrosis and steady-state bronchiectasis.
Design: Prospective, cross-sectional clinicomicrobiological study with informed consent.
Setting: Consecutive outpatient recruitment from a specialist bronchiectasis respiratory clinic.
Patients: Outpatients (n = 100; 62 women; 55.1 ± 16.7 years old; FEV1/FVC 1.4 ± 0.7/2.1 ± 0.9 L), who had stable respiratory symptoms for more than 3 weeks.
Measurements and results: Respiratory pathogens isolated from the sputum were: Pseudomonas aeruginosa (33), Haemophilus influenzae (10), Moraxella catarrhalis (2), other Gram-negative bacilli (5), Streptococcus pneumoniae (6), Staphylococcus aureus (5), mycobacteria (3), and yeast (1). Clinical parameters in patients with positive isolation of P aeruginosa were compared with those without the organism in the sputum culture (non-P aeruginosa). In the P aeruginosa group, the FEV1/FVC ratio and sputum volume were lower (p < 0.005) and higher (p < 0.0001), respectively, than those of the non-P aeruginosa group. The FEV1/FVC ratio (< 60%) and sputum volume (grading > 5) were independently associated with a positive sputum isolation of P aeruginosa with odds ratios of 3.1 (confidence interval [CI] 1.2 to 8.4; p < 0.01) and 4.7 (CI 1.6 to 13.3; p < 0.001), respectively.
Conclusions: P aeruginosa is the predominant respiratory pathogen isolated in the sputum of Chinese patients with steady-state bronchiectasis, and its isolation is associated with high sputum output (
75th quartile) and moderately severe airflow obstruction (FEV1/FVC < 60%).
Key Words: bronchiectasis • Pseudomonas aeruginosa • sputum pathogens
Submitted on January 15, 1998
Accepted on June 29, 1998
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