Sputum microbiology data and related clinical outcomes among adult Aboriginal Australians with bronchiectasis.

IF 1.8 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Claire Gibbs, Timothy Howarth, Sudharsan Venkatesan, Sanjana S Heraganahally, Asanga Abeyaratne, Subash S Heraganahally
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引用次数: 0

Abstract

Background: Sputum microbiology is an integral aspect of managing patients with bronchiectasis. Adult Aboriginal Australians have a high bronchiectasis disease burden; however, as yet there is sparce literature detailing the sputum microbiology profile in this population.

Aims: To assess the sputum microbiology profile among Aboriginal patients aged ≥18 years with chest computed tomography-confirmed bronchiectasis in the Top End Northern Territory of Australia.

Method: All available sputum samples processed in a single laboratory service with established protocols for examining and reporting sputum microbiology results between 2011 through 2020 were assessed in relation to demographics, lung function parameters, chest radiology, inhaled pharmacotherapy, hospital admissions restricted to respiratory conditions and all-cause mortality.

Results: Four hundred twenty-eight patients (median age 47 years, 56% female) had sputum cultures available to assess. Haemophilus spp. was the most common (64%), followed by yeast/Candida spp. (53%) and Pseudomonas spp. (36%). Polymicrobial cultures were noted in 92% of patients. There were significant geographic differences on a region-wise and community-wise basis. Patients with yeast/Candida spp. and Pseudomonas spp. recorded more hospitalisations (median 7 (interquartile range (IQR) 3-14) and 8 (IQR 4-16)). In multivariate models, both yeast/Candida spp. (odds ratio (OR) 2.63 (95% confidence interval (CI) 1.68-4.14)) and Pseudomonas spp. (OR 1.95 (95% CI 1.25-3.04)) were associated with increased odds for mortality. Other than higher Pseudomonas spp. isolated with the use of inhaled corticosteroids, no significant association was observed either with lung function or chest radiology.

Conclusion: Adult Aboriginal Australians with bronchiectasis harbour a significant microorganism load that may play a role in overall morbidity and mortality.

成年澳大利亚原住民支气管扩张患者的痰微生物学数据和相关临床结果。
背景:痰微生物学是支气管扩张患者管理的一个重要方面。成年澳大利亚土著居民有很高的支气管扩张疾病负担;然而,到目前为止,还没有详细介绍这一人群的痰微生物学概况的文献。目的:评估≥18岁澳大利亚北部地区经胸部计算机断层扫描证实的支气管扩张的土著患者的痰微生物学特征。方法:对2011年至2020年间在单一实验室服务中处理的所有可获得的痰样本进行人口统计学、肺功能参数、胸部放射学、吸入药物治疗、呼吸系统疾病住院率和全因死亡率的评估。结果:428例患者(中位年龄47岁,56%为女性)有痰培养物可用于评估。最常见的是嗜血杆菌(64%),其次是酵母菌/念珠菌(53%)和假单胞菌(36%)。92%的患者有多种微生物培养。在地区和社区的基础上存在显著的地理差异。感染酵母菌/念珠菌和假单胞菌的患者住院率更高(中位数为7(四分位数范围(IQR) 3-14)和8 (IQR 4-16))。在多变量模型中,酵母菌/念珠菌(比值比(OR) 2.63(95%可信区间(CI) 1.68-4.14)和假单胞菌(OR) 1.95 (95% CI 1.25-3.04)均与死亡率增加相关。除了使用吸入皮质类固醇分离出较高的假单胞菌外,没有观察到肺功能或胸部放射学的显著相关性。结论:成年澳大利亚土著居民支气管扩张携带显著的微生物负荷,可能在总体发病率和死亡率中起作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Internal Medicine Journal
Internal Medicine Journal 医学-医学:内科
CiteScore
3.50
自引率
4.80%
发文量
600
审稿时长
3-6 weeks
期刊介绍: The Internal Medicine Journal is the official journal of the Adult Medicine Division of The Royal Australasian College of Physicians (RACP). Its purpose is to publish high-quality internationally competitive peer-reviewed original medical research, both laboratory and clinical, relating to the study and research of human disease. Papers will be considered from all areas of medical practice and science. The Journal also has a major role in continuing medical education and publishes review articles relevant to physician education.
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