Clinical Implications of Pseudomonas Aeruginosa Colonization in Chronic Obstructive Pulmonary Disease Patients.

Abstract

Background: Pseudomonas aeruginosa is an important pathogen in patients with chronic respiratory diseases. It can colonize the airway and could have prognostic value in bronchiectasis and cystic fibrosis. Its role in chronic obstructive pulmonary disease (COPD) is less well defined.

Methods: A prospective study was conducted in Hong Kong to investigate the possible association between Pseudomonas aeruginosa colonization and acute exacerbation of COPD (AECOPD) risks.

Results: Among 327 Chinese patients with COPD included, 33 (10.1%) of the patients had Pseudomonas aeruginosa colonization. Patients with or without Pseudomonas aeruginosa colonization had similar background characteristics. Patients with Pseudomonas aeruginosa colonization had increased risks of moderate to severe AECOPD, severe AECOPD and pneumonia with adjusted odds ratio (aOR) of 3.15 (95% CI 1.05 - 9.48, p = 0.042), 2.59 (95% CI 1.01 - 6.64, p = 0.048) and 4.19 (95% CI 1.40 - 12.54, p = 0.011) respectively. Patients with Pseudomonas aeruginosa colonization also had increased annual frequency of moderate to severe AECOPD, median 0 [0 - 0.93] in the non-Pseudomonas aeruginosa colonization group and 1.35 [0 - 3.39] in the Pseudomonas aeruginosa colonization group, with a p-value of 0.005 in multi-variate linear regression.

Conclusion: Pseudomonas aeruginosa colonization is a potential independent risk factor for moderate to severe AECOPD and pneumonia among patients with COPD without co-existing bronchiectasis.