Microbiology sampling in non-cystic fibrosis bronchiectasis cases from northern Alberta

PLoS One. 2023 Jul 14;18(7):e0288704. doi: 10.1371/journal.pone.0288704. eCollection 2023.

Abstract

Non-cystic fibrosis bronchiectasis (NCFB) is a chronic respiratory disease resulting in chronic cough, thick sputum, and lower airway microbial colonization, akin to patients with cystic fibrosis (CF). NCFB is a common, yet under recognized entity which inflicts significant morbidity and mortality particularly to older individuals, with a rising prevalence in the developed world. Given that sputum cultures are a non-invasive method to characterize the lower airway microbiota in NCFB patients, for which pathogenic organisms are associated with worsened outcomes, we sought to characterize the microbiological pattern and clinical outcomes associated with sputum culture in a cohort of NCFB patients from Western Canada. A total of 20 subjects were prospectively recruited from various bronchiectasis clinics across the Greater Edmonton area. A retrospective chart review and a symptoms questionnaire was performed, gathering information not limited to symptoms, comorbidities, exacerbations, hospitalizations, sputum production, and sputum culture results over the prior 5 years. Subjects reported frequent hospitalization alongside a significant burden of symptoms. A large majority of sputum cultures grew pathogenic organisms such as Haemophilus influenzae and Pseudomonas aeruginosa. We also note the considerable waste and inefficiency associated with sputum cultures, outlining areas for which this important diagnostic modality can be improved. Accurate characterization of the airway microbiota alongside efficient delivery of health services are key to ensuring the proper treatment of individuals with NCFB, given their high disease burden and frequent hospitalization.

MeSH terms

  • Alberta / epidemiology
  • Anti-Bacterial Agents / therapeutic use
  • Bronchiectasis* / complications
  • Cystic Fibrosis* / complications
  • Cystic Fibrosis* / drug therapy
  • Fibrosis
  • Humans
  • Pseudomonas Infections* / drug therapy
  • Pseudomonas aeruginosa
  • Retrospective Studies
  • Sputum / microbiology

Substances

  • Anti-Bacterial Agents

Grants and funding

Author MD was compensated with a Office of the Provost and VP (Academic) Summer Research Award. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.