Characterising patients with bronchiectasis and persistently negative sputum cultures: data from the European Bronchiectasis Registry EMBARC.

<bold>Introduction:</bold> Chronic infection with pathogens is a key feature of bronchiectasis. Despite this, some patients will have persistently negative sputum cultures despite high disease burden. This group of patients has not been previously described or characterised. <bold>Methods:</bold> We examined patients enrolled into the European Bronchiectasis registry (EMBARC) between 2015 and 2022. We defined negative microbiology as at least 2 negative samples with no positive samples in the year prior to baseline in the registry. <bold>Results:</bold> 18843 patients were included in the study. 28272 sputum samples were sent during the study period, 17237 (61%) at stable state and 11035 (39%) at exacerbation. 6082 patients had at least 2 cultures available. 1152 (18.9%) of patients with at least 2 samples sent were found to have persistently negative cultures and compared with 4923 with at least one positive culture. Persistently negative cultures were associated with current smoking (7.5% vs 4.5%), a lower daily sputum volume (mean 37.5mls vs 48mls) and less severe disease. This group of patients was not strongly associated with a particular aetiology of bronchiectasis except for inflammatory Bowel Disease (IBD) (OR 2.0). Patients with persistently negative cultures had a similar rate of exacerbations (rate ratio 0.92 95%CI 0.83-1.02p=0.092) but lower hospitalisation rate (RR 0.84 95%CI 0.72-0.98, p=0.02) and lower mortality HR0.76 95%CI 0.59-0.98, p=0.03). <bold>Conclusion:</bold> 18.9% patients with 2 or more sputum samples sent have persistently negative cultures. This group are not easily distinguishable from the group with airway infection and includes patients with high disease burden.

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Published
2024-09-14
DOI
https://doi.org/10.1183/13993003.congress-2024.pa2379
Primary Topic
Cystic Fibrosis Research Advances
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article
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article

Characterising patients with bronchiectasis and persistently negative sputum cultures: data from the European Bronchiectasis Registry EMBARC.

Adam T. Hill, Wim Boersma, Josje Altenburg, Michal Shteinberg et al.
Cystic Fibrosis Research Advances
article

Characterising patients with bronchiectasis and persistently negative sputum cultures: data from the European Bronchiectasis Registry EMBARC.

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

Abstract

<bold>Introduction:</bold> Chronic infection with pathogens is a key feature of bronchiectasis. Despite this, some patients will have persistently negative sputum cultures despite high disease burden. This group of patients has not been previously described or characterised. <bold>Methods:</bold> We examined patients enrolled into the European Bronchiectasis registry (EMBARC) between 2015 and 2022. We defined negative microbiology as at least 2 negative samples with no positive samples in the year prior to baseline in the registry. <bold>Results:</bold> 18843 patients were included in the study. 28272 sputum samples were sent during the study period, 17237 (61%) at stable state and 11035 (39%) at exacerbation. 6082 patients had at least 2 cultures available. 1152 (18.9%) of patients with at least 2 samples sent were found to have persistently negative cultures and compared with 4923 with at least one positive culture. Persistently negative cultures were associated with current smoking (7.5% vs 4.5%), a lower daily sputum volume (mean 37.5mls vs 48mls) and less severe disease. This group of patients was not strongly associated with a particular aetiology of bronchiectasis except for inflammatory Bowel Disease (IBD) (OR 2.0). Patients with persistently negative cultures had a similar rate of exacerbations (rate ratio 0.92 95%CI 0.83-1.02p=0.092) but lower hospitalisation rate (RR 0.84 95%CI 0.72-0.98, p=0.02) and lower mortality HR0.76 95%CI 0.59-0.98, p=0.03). <bold>Conclusion:</bold> 18.9% patients with 2 or more sputum samples sent have persistently negative cultures. This group are not easily distinguishable from the group with airway infection and includes patients with high disease burden.

Queen's University Belfast (GB), Humanitas University (IT), Inserm (FR), University of Milan (IT), University of Aberdeen (GB), Université Paris Cité (FR), Royal Papworth Hospital (GB), Ninewells Hospital (GB), Harefield Hospital (GB), Edinburgh Royal Infirmary (GB), Centre Hospitalier Universitaire de Toulouse (FR), Medizinische Hochschule Hannover (DE), Assistance Publique – Hôpitaux de Paris (FR), Northwest Hospital (US), Institut d'Investigació Biomèdica de Girona (ES), Carmel Medical Center (IL), Hospital Clínic de Barcelona (ES), Vall d'Hebron Hospital Universitari (ES), NIHR Newcastle Biomedical Research Centre (GB), Institut Cochin (FR), Hospital Universitari de Girona Doctor Josep Trueta (ES), AZ Sint-Lucas (BE), Instituto de Investigación Sanitaria La Fe (ES), Sotiria General Hospital (GR), Universitat de Barcelona (ES), University of Amsterdam (NL)
Openalex Percentile: Top 63%
Cystic Fibrosis Research Advances
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