Infection with Staphylococcus aureus in patients with bronchiectasis: data from the EMBARC registry

<bold>Introduction:</bold> <italic>Staphylococcus aureus</italic> is one of the most common pathogens identified in patients with bronchiectasis, but less is known about its impact on outcomes compared to the Gram negative pathogens. <bold>Methods:</bold> Analysis of the EMBARC bronchiectasis registry, a prospective observational study conducted across 31 European and non-European countries. Patients with a single isolation of <italic>S. aureus</italic> in stable state were identified. Logistic regression was used to explore factors associated with <italic>S. aureus</italic> isolation. Outcomes were exacerbations, hospitalizations and mortality over up to 5 years follow-up. <bold>Results:</bold> 19324 patients were included for analysis. <italic>S. aureus</italic> infection in the year prior was identified in 1098 patients (5.7%). <italic>S.aureus</italic> infection was associated with younger age (OR 0.98 95%CI 0.97-0.99) and isolation of other pathogens including <italic>P. aeruginosa</italic> and <italic>H.influenzae</italic> (all p<0.001). <italic>S. aureus</italic> was less common in current smokers (OR 0.40 95%CI 0.26-0.60) and patients with asthma OR 0.76 95CI 0.65-0.90). In contrast to other pathogens no geographical variation in <italic>S. aureus</italic> infection was observed. Most aetiologies had similar frequency of <italic>S. aureus</italic> except for a higher risk in patients with alpha-1 antitrypsin deficiency (Odds ratio 2.65 95%CI 1.49-4.72). No relationship was observed between <italic>S. aureus</italic> isolation and exacerbation (RR 0.90 95%CI 0.81-1.01), hospitalization RR 1.12 95%CI 0.95-1.32 or mortality HR 0.93 95%CI 0.71-1.21. <bold>Conclusion:</bold> <italic>Staphylococcus aureus</italic> infection was not associated with differences in clinical outcomes.

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Published
2024-09-14
DOI
https://doi.org/10.1183/13993003.congress-2024.pa5067
Primary Topic
Cystic Fibrosis Research Advances
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article
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article

Infection with Staphylococcus aureus in patients with bronchiectasis: data from the EMBARC registry

Adam T. Hill, PC Goeminne, Francesco Blasi, Michael R. Loebinger et al.
Cystic Fibrosis Research Advances
article

Infection with Staphylococcus aureus in patients with bronchiectasis: data from the EMBARC registry

Adam T. Hill, PC Goeminne, Francesco Blasi, Michael R. Loebinger, Josje Altenburg, Michal Shteinberg, Charles Haworth, J.S. Elborn, Felix C. Ringshausen, Eva Polverino, Katerina Dimakou, Rosario Menéndez, James Duncan Chalmers, Tobias Welte, Montserrat Vendrell, Anthony De Soyza, Pierre‐Régis Burgel, Stefano Aliberti, Jessica Rademacher, Antoní Torres, Marlène Murris, Robert Wilson, Wim Boersma
article en

Abstract

<bold>Introduction:</bold> <italic>Staphylococcus aureus</italic> is one of the most common pathogens identified in patients with bronchiectasis, but less is known about its impact on outcomes compared to the Gram negative pathogens. <bold>Methods:</bold> Analysis of the EMBARC bronchiectasis registry, a prospective observational study conducted across 31 European and non-European countries. Patients with a single isolation of <italic>S. aureus</italic> in stable state were identified. Logistic regression was used to explore factors associated with <italic>S. aureus</italic> isolation. Outcomes were exacerbations, hospitalizations and mortality over up to 5 years follow-up. <bold>Results:</bold> 19324 patients were included for analysis. <italic>S. aureus</italic> infection in the year prior was identified in 1098 patients (5.7%). <italic>S.aureus</italic> infection was associated with younger age (OR 0.98 95%CI 0.97-0.99) and isolation of other pathogens including <italic>P. aeruginosa</italic> and <italic>H.influenzae</italic> (all p<0.001). <italic>S. aureus</italic> was less common in current smokers (OR 0.40 95%CI 0.26-0.60) and patients with asthma OR 0.76 95CI 0.65-0.90). In contrast to other pathogens no geographical variation in <italic>S. aureus</italic> infection was observed. Most aetiologies had similar frequency of <italic>S. aureus</italic> except for a higher risk in patients with alpha-1 antitrypsin deficiency (Odds ratio 2.65 95%CI 1.49-4.72). No relationship was observed between <italic>S. aureus</italic> isolation and exacerbation (RR 0.90 95%CI 0.81-1.01), hospitalization RR 1.12 95%CI 0.95-1.32 or mortality HR 0.93 95%CI 0.71-1.21. <bold>Conclusion:</bold> <italic>Staphylococcus aureus</italic> infection was not associated with differences in clinical outcomes.

Queen's University Belfast (GB), Université Fédérale de Toulouse Midi-Pyrénées (FR), Université Paris Cité (FR), Royal Papworth Hospital (GB), Ninewells Hospital (GB), Harefield Hospital (GB), Edinburgh Royal Infirmary (GB), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT), Centre Hospitalier Universitaire de Toulouse (FR), Medizinische Hochschule Hannover (DE), Hôpital Cochin (FR), Assistance Publique – Hôpitaux de Paris (FR), Institut d'Investigació Biomèdica de Girona (ES), Carmel Medical Center (IL), Hospital Clínic de Barcelona (ES), NIHR Newcastle Biomedical Research Centre (GB), Mykolaiv Observatory (UA), Amsterdam University Medical Centers (NL), Hospital Universitari de Girona Doctor Josep Trueta (ES), Medisch Centrum Alkmaar (NL), Consorci Institut D'Investigacions Biomediques August Pi I Sunyer (ES), IRCCS Humanitas Research Hospital (IT), Instituto de Investigación Sanitaria La Fe (ES), Sotiria General Hospital (GR), Universitat de Barcelona (ES), University of Amsterdam (NL)
Openalex Percentile: Top 64%
Cystic Fibrosis Research Advances
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