Pseudomonas aeruginosa associated with severity of non-cystic fibrosis bronchiectasis measured by the modified bronchiectasis severity score (BSI) and the FACED: The US bronchiectasis and NTM Research Registry (BRR) study

Radmila Choate, Timothy R. Aksamit, David Mannino, Doreen Addrizzo-Harris, Alan Barker, Ashwin Basavaraj, Charles L. Daley, M. Leigh Anne Daniels, Edward Eden, Angela DiMango, Kevin Fennelly, David E. Griffith, Margaret M. Johnson, Michael R. Knowles, Pamela J. McShane, Mark L. Metersky, Peadar G. Noone, Anne E. O'Donnell, Kenneth N. Olivier, Matthias A. SalatheAndreas Schmid, Byron Thomashow, Gregory Tino, Kevin L. Winthrop, Glenda Stone

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Rationale: Non-cystic fibrosis bronchiectasis (NCFB) is characterized by dilated bronchi, poor mucus clearance and susceptibility to bacterial infection. Pseudomonas aeruginosa (PA) is one of the most frequently isolated pathogens in patients with NCFB. The purpose of this study was to evaluate the association between presence of PA and disease severity in patients within the US Bronchiectasis and Nontuberculous mycobacteria (NTM) Research Registry (BRR). Methods: Baseline US BRR data from adult patients with NCFB collected between 2008 and 2018 was used for this study. The presence of PA was defined as one or more positive PA cultures within two years prior to enrollment. Modified Bronchiectasis Severity Index (m-BSI) and modified FACED (m-FACED) were computed to evaluate severity of bronchiectasis. Unadjusted and multivariable multinomial regression models were used to assess the association between presence of PA and severity of bronchiectasis. Results: Average age of the study participants (n = 1831) was 63.7 years (SD = 14.1), 91.5% white, and 78.8% female. Presence of PA was identified in 25.4% of the patients. Patients with presence of PA had significantly lower mean pre-bronchodilator FEV1% predicted compared to those without PA (62.8% vs. 73.7%, p <.0001). In multivariate analyses, patients with presence of PA had significantly greater odds for having high (ORadj = 6.15 (95%CI:3.98–9.50) and intermediate (ORadj = 2.06 (95%CI:1.37–3.09) severity vs. low severity on m-BSI. Conclusion: The presence of PA is common in patients with NCFB within the Bronchiectasis and NTM Research Registry. Severity of bronchiectasis is significantly greater in patients with PA which emphasizes high burden of the disease.

Original languageEnglish
Article number106285
JournalRespiratory Medicine
Volume177
DOIs
StatePublished - Feb 2021

Bibliographical note

Funding Information:
DA-H has served on a research protocol advisory board for AIT Therapeutics and has served in an educational lecture series sponsored by Insmed. TRA has participated in clinical trials sponsored by Bayer, Aradigm, Zambon, and Insmed but has not received any personal or research support. ABarker has received grant support from COPD Foundation for participation in the Bronchiectasis and NTM Research Registry. ABasavaraj has received grant support from COPD Foundation for participation in the Bronchiectasis and NTM Research Registry, has served on the advisory board and consultant for Insmed, and consultant for Hill-Rom. AS has served on the Speaker Bureau and Advisory Board for Insmed. CLD has received grant support from COPD Foundation and Insmed. DM is a former employee and a current shareholder of GlaxoSmithKline. MLAD has served on Speaker Bureau/Advisory Boards for Spark Partners and Insmed and participated in clinical trials for Zambon and Parion/Vertex. MLM has received grant support from COPD Foundation. PGN has received grant support from Aradigm/Grifols, Insmed, Parion/ Vertex and Bayer, and consultancy fees from Bayer, Grifols, and Smartvest. AEO has received grant support from Parion, Insmed, Aradigm, Grifols, and COPD Foundation. KNO has a Cooperative Research and Development Award with AIT Therapeutics (Beyond Air) and Matinas Biopharma and has participated on advisory panels with Insmed, Inc. MAS has received grant support from COPD Foundation, Parion, Bayer Healthcare, and Aradigm. BMT has received personal fees for serving on advisory boards for GlaxoSmithKline and AstraZeneca and helped cofound the COPD Foundation and served as the Foundation’s Board Chairman for ten years. GT has received grant support from the COPD Foundation for participation in the Bronchiectasis and NTM Research Registry and has received personal fees for serving on Advisory Boards for Bayer, Grifols, Aradigm, and Cipla. KLW has received grant support and personal fees from Insmed and Bayer. No conflicts declared from RC, AD, EE, KF, DG, MMJ, MRK and GS.

Funding Information:
This research was sponsored by Grifols .

Publisher Copyright:
© 2020 Elsevier Ltd

Keywords

  • Bronchiectasis severity
  • Non-cystic fibrosis bronchiectasis
  • Pseudomonas aeruginosa
  • Registry
  • Severity scores

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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