Impact of Multi-Drug Resistant Bacterial Infections on Patients With Bronchiectasis

A study published in the Annals of Clinical Microbiology and Antimicrobials explores the impact of multidrug-resistant (MDR) bacterial infections on the clinical outcomes of adult patients with bronchiectasis, finding a significant increase in in-hospital and 3-year mortality rates compared to non-MDR infected patients.

Over 10 years, the study compared in-hospital and 3-year mortality rates between patients with bronchiectasis identified from the Chang Gung Research Database and patients with bronchiectasis and MDR bacterial infections.

A total of 554 patients with both bronchiectasis and MDR bacterial infection were identified, with the most common MDR bacteria being MDR- Acinetobacter baumannii and methicillin-resistant Staphylococcus aureus. The MDR group had lower body mass index scores, higher rates of chronic bacterial colonization, previous exacerbations, and antibiotic use than the control group. 

Additionally, the MDR group had a higher rate of respiratory failure during hospitalization. In-hospital mortality rates, 3-year respiratory failure rates, and 3-year mortality rates were all significantly higher in the MDR group compared to the control group. Adjustment for confounding factors showed that MDR infection and specific MDR bacterial species were independent risk factors for in-hospital and 3-year mortality.

“MDR bacteria were discovered in patients with more severe bronchiectasis and were independently associated with an increased risk of in-hospital and 3-year mortality,” said researchers. “Given our findings, we recommend that clinicians identify patients at risk of MDR bacterial infection and follow the principle of antimicrobial stewardship to prevent the emergence of resistant bacteria among patients with bronchiectasis.” 

Reference
Chang CH, Chang, CH, Huang SH, et al. Epidemiology and outcomes of multidrug-resistant bacterial infection in non-cystic fibrosis bronchiectasis. Ann Clin Microbiol Antimicrob. 2024;23(15). doi:10.1186/s12941-024-00675-6