Non CF-bronchiectasis: Aetiologic approach, clinical, radiological, microbiological and functional profile in 277 patients

Respir Med. 2016 Jul;116:1-7. doi: 10.1016/j.rmed.2016.05.001. Epub 2016 May 3.

Abstract

Background and objectives: Non-Cystic Fibrosis (CF) bronchiectasis is common in Greece but little attention has been paid to the investigation of its aetiology, clinical, radiological, microbiological and lung function profile.

Methods: We prospectively evaluated patients with non-CF bronchiectasis confirmed by high resolution computed tomography (HRCT) of the chest. Aetiology, clinical data, radiology score, microbiological profile and lung function were investigated.

Results: We evaluated 277 patients (170 women) with bronchiectasis (mean age: 60.5 ± 16 years), 64% of them being non-smokers. Post-infectious (25.2%) and past tuberculosis (TB) (22.3%) were the most commonly identified underlying conditions, while no cause was found in 34% of the patients. The main symptoms were cough (82%), mucopurulent sputum (80%), dyspnea (60%) and haemoptysis (37%). Mean duration of symptoms was 9.7 (SD 10.7) years. Infectious exacerbations were observed in 67.5% of the patients with a mean frequency of 2.3 (SD 1.4) per year. The most frequent lung function pattern was the obstructive (43.1%) while 38% of the patients had normal spirometry. Pseudomonas aeruginosa was the most common pathogen yielded in sputum cultures (43%) followed by Haemophilus influenzae (12.6%). Patients with P. aeruginosa had a more long-standing disease and worse lung function. Radiological severity of the disease was mainly related to impaired lung function, P. aeruginosa isolation in sputum and frequent exacerbations.

Conclusion: Data indicate that in Greece, "past" tuberculosis remains an important cause of bronchiectasis. P. aeruginosa was the predominant pathogen in the airways, associated with disease severity, while the most common lung function impairment was obstruction.

Keywords: Bronchiectasis; Epidemiology; Lung function; Microbiology; Radiology.

MeSH terms

  • Aged
  • Airway Obstruction / complications
  • Airway Obstruction / physiopathology
  • Bronchiectasis / diagnostic imaging*
  • Bronchiectasis / etiology*
  • Bronchiectasis / microbiology*
  • Bronchiectasis / physiopathology
  • Disease Progression
  • Female
  • Greece / epidemiology
  • Haemophilus influenzae / isolation & purification
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Pseudomonas Infections / complications
  • Pseudomonas aeruginosa / isolation & purification
  • Radiography / methods
  • Respiratory Function Tests / methods
  • Respiratory System / microbiology
  • Severity of Illness Index
  • Spirometry
  • Sputum / microbiology
  • Tomography, X-Ray Computed / methods
  • Tuberculosis, Pulmonary / complications
  • Tuberculosis, Pulmonary / epidemiology