Risk Factors for Multidrug-resistant Pathogens in Bronchiectasis Exacerbations

Overview

Journal BMC Infect Dis

Publisher Biomed Central

Specialty Infectious Diseases

Date 2017 Oct 2

PMID 28964261

Citations 13

Authors

Rosario Menendez

Raul Mendez

Eva Polverino

Edmundo Rosales-Mayor

Isabel Amara-Elori

Soledad Reyes

Jose Miguel Sahuquillo-Arce

Laia Fernandez-Barat

Victoria Alcaraz

Antoni Torres

Affiliations

Soon will be listed here.

Abstract

Background: Non-cystic fibrosis bronchiectasis is a chronic structural lung condition that courses with recurrent infectious exacerbations that lead to frequent antibiotic treatment making this population more susceptible to acquire pathogens with antibiotic resistance. We aimed to investigate risk factors associated with isolation of multidrug-resistant pathogens in bronchiectasis exacerbations.

Methods: A prospective observational study was conducted in two tertiary-care hospitals, enrolling patients when first exacerbation appeared. Multidrug-resistance was determined according to European Centre of Diseases Prevention and Control classification.

Results: Two hundred thirty three exacerbations were included and microorganisms were isolated in 159 episodes. Multidrug-resistant pathogens were found in 20.1% episodes: Pseudomonas aeruginosa (48.5%), methicillin-resistant Staphylococcus aureus (18.2%) and Extended spectrum betalactamase + Enterobacteriaceae (6.1%), and they were more frequent in exacerbations requiring hospitalization (24.5% vs. 10.2%, p: 0.016). Three independent multidrug-resistant risk factors were found: chronic renal disease (Odds ratio (OR), 7.60, 95% CI 1.92-30.09), hospitalization in the previous year (OR, 3.88 95% CI 1.37-11.02) and prior multidrug-resistant isolation (OR, 5.58, 95% CI 2.02-15.46). The proportion of multidrug-resistant in the 233 exacerbations was as follows: 3.9% in patients without risk factors, 12.6% in those with 1 factor and 53.6% if ≥2 risk factors.

Conclusions: Hospitalization in the previous year, chronic renal disease, and prior multidrug-resistant isolation are risk factors for identification multidrug-resistant pathogens in exacerbations. This information may assist clinicians in choosing empirical antibiotics in daily clinical practice.

Citing Articles

Factors Associated With Multi-Drug Resistant Organisms Among Bronchiectasis Patients: A Retrospective Study of Bronchiectasis Patients in Jordan.

Al Oweidat K, Toubasi A, Khraisat F, Al-Sayegh T, Al-Harasis L, Albtoosh A Int J Gen Med. 2025; 18:391-402.

PMID: 39881954 PMC: 11776428. DOI: 10.2147/IJGM.S490196.

Exacerbations of bronchiectasis.

De Angelis A, Johnson E, Sutharsan S, Aliberti S Eur Respir Rev. 2024; 33(173).

PMID: 39048130 PMC: 11267293. DOI: 10.1183/16000617.0085-2024.

Epidemiology and outcomes of multidrug-resistant bacterial infection in non-cystic fibrosis bronchiectasis.

Chang C, Chang C, Huang S, Lee C, Ko P, Lin C Ann Clin Microbiol Antimicrob. 2024; 23(1):15.

PMID: 38350983 PMC: 10865664. DOI: 10.1186/s12941-024-00675-6.

Assessment of risk factors associated with multidrug-resistant organism infections among patients admitted in a tertiary hospital - a retrospective study.

Alsehemi A, Alharbi E, Alammash B, Alrais A, Elbadawy H, Alahmadi Y Saudi Pharm J. 2023; 31(6):1084-1093.

PMID: 37293381 PMC: 10244471. DOI: 10.1016/j.jsps.2023.03.019.

Multidrug-resistant organism-peritoneal dialysis associated peritonitis: clinical and microbiological features and risk factors of treatment failure.

Guo S, Yang L, Zhu X, Zhang X, Meng L, Li X Front Med (Lausanne). 2023; 10:1132695.

PMID: 37234246 PMC: 10208398. DOI: 10.3389/fmed.2023.1132695.

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