Pattern of bacterial infection in acute exacerbation of bronchiectasis according to the lobar distribution

Shipan Chandra Paul; Gopal Chandra Sarkar; Susanta Kumar Paul; Rajashish Chakrabortty; Shamim Ahmed; Mohammed Atiqur Rahman

doi:10.18203/2320-6012.ijrms20231309

Authors

Shipan Chandra Paul Department of Respiratory Medicine, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka-1000, Bangladesh
Gopal Chandra Sarkar Department of Respiratory Medicine, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka-1000, Bangladesh
Susanta Kumar Paul Department of Respiratory Medicine, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka-1000, Bangladesh
Rajashish Chakrabortty Department of Respiratory Medicine, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka-1000, Bangladesh
Shamim Ahmed Department of Respiratory Medicine, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka-1000, Bangladesh
Mohammed Atiqur Rahman Department of Respiratory Medicine, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka-1000, Bangladesh

DOI:

https://doi.org/10.18203/2320-6012.ijrms20231309

Keywords:

Bacterial profile, Bronchiectasis, Lobar distribution

Abstract

Background: The pattern of bacterial infection in acute exacerbation of bronchiectasis is varied with geographical area and lobar distribution of bronchiectasis. The exact pattern of bacterial infection in acute exacerbation of bronchiectasis according to lobar distribution is not known in our country. This study aimed to investigate the pattern of bacterial infection in acute exacerbation of bronchiectasis according to lobar distribution.

Methods: A total of eighty-four patients diagnosed with acute exacerbation of bronchiectasis were included in this cross-sectional study in the department of respiratory medicine, Bangabandhu Sheikh Mujib Medical University. Sputum culture and real-time polymerase chain reaction were used to characterize the bacterial profile and high-resolution computed tomography scans for the location of the bronchiectasis. Before enrolment, informed written consent was obtained from the participants.

Results: The mean (SD) age of this study population was 47.89 (±14.95) years, 29.8% were female and 60.7% were a non-smoker. Bronchiectasis was more common in the right middle lobe (63.1%), followed by the right lower lobe (44%), and the left lower lobe (42%). Bacteria were isolated in 66% of patients and Gram-negative bacteria were predominant (78.6%). Pseudomonas aeruginosa (25%) and Klebsiella pneumoniae (17.9%) were the most common bacteria.

Conclusions: Pseudomonas aeruginosa was identified predominantly in the right upper lobe, right middle lobe, left upper lobe, and bilateral upper lobe and Klebsiella pneumoniae was in the right lower lobe, left lower lobe, and bilateral lower lobe.

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References

Polverino E, Goeminne PC, McDonnell MJ, Aliberti S, Marshall SE, Loebinger MR, et al. European Respiratory Society guidelines for the management of adult bronchiectasis. Eur Respir J. 2017;50(3):1700629.

Chandrasekaran R, Mac Aogáin M, Chalmers JD, Elborn SJ, Chotirmall SH. Geographic variation in the etiology, epidemiology, and microbiology of bronchiectasis. BMC Pulmon Med. 2018;18(1):1-4.

Chalmers JD, Aliberti S, Blasi F. Management of bronchiectasis in adults. Eur Respir J. 2015;45(5):1446-62.

Hill AT, Haworth CS, Aliberti S, Barker A, Blasi F, Boersma W, et al. EMBARC/BRR definitions working group. Pulmonary exacerbation in adults with bronchiectasis: a consensus definition for clinical research. Eur Respir J. 2017;49(6):1700051.

Dhar R, Singh S, Talwar D, Mohan M, Tripathi SK, Swarnakar R, et al. Bronchiectasis in India: results from the European multicentre bronchiectasis audit and research collaboration (EMBARC) and respiratory research network of India registry. Lancet Glob Health. 2019;7(9): e1269-79.

Byun MK, Chang J, Kim HJ, Jeong SH. Differences of the lung microbiome in patients with clinically stable and exacerbated bronchiectasis. PLoS One. 2017;12(8): e0183553.

Dimakou K, Triantafillidou C, Toumbis M, Tsikritsaki K, Malagari K, Bakakos P. Non-CF-bronchiectasis: Aetiologic approach, clinical, radiological, microbiological and functional profile in 277 patients. Respir Med. 2016;116:1-7.

Lonni S, Chalmers JD, Goeminne PC, McDonnell MJ, Dimakou K, De Soyza A, et al. Etiology of non–cystic fibrosis bronchiectasis in adults and its correlation to disease severity. Ann Am Thorac Soc. 2015;12(12):1764-70.

Izhakian S, Wasser WG, Fuks L, Vainshelboim B, Fox BD, Fruchter O, et al. Lobar distribution in non-cystic fibrosis bronchiectasis predicts bacteriologic pathogen treatment. Eur J Clin Microbiol Infect Dis. 2016;35(5):791-6.

Shoemark A, Ozerovitch L, Wilson R. Aetiology in adult patients with bronchiectasis. Respir Med. 2007;101(6):1163-70.

Shahid S, Jabeen K, Iqbal N, Farooqi J, Irfan M. Respiratory pathogens in patients with acute exacerbation of non-cystic fibrosis bronchiectasis from a developing country. Monaldi Arch Chest Dis. 2021;91(2).

Murray MP, Turnbull K, MacQuarrie S, Hill AT. Assessing response to treatment of exacerbations of bronchiectasis in adults. Eur Respir J. 2009;33(2):312-8.

Tsang KW, Chan WM, Ho PL, Chan K, Lam WK, Ip MS. A comparative study on the efficacy of levofloxacin and ceftazidime in acute exacerbation of bronchiectasis. Eur Respir J. 1999;14(5):1206-9.

Davies G, Wells AU, Doffman S, Watanabe S, Wilson R. The effect of Pseudomonas aeruginosa on pulmonary function in patients with bronchiectasis. Eur Respir J. 2006;28(5):974-9.

Saha SK, Baqui AH, Darmstadt GL, Islam M, Arifeen SE, Santosham M, et al. Addition of isovitalex in chocolate agar for the isolation of Haemophilus influenzae. Indian J Med Res. 2009;129(1):99-102.