Pseudomonas aeruginosa is recognized as the main pathogen responseible for the morbidity and mortality of cystic fibrosis (CF) patients. P. aeruginosa has also been found as a colonizer of lungs in a significant proportion of adults with chronic obstructive pulmonary disease (COPD). A hallmark of chronic infection of the CF airways is an event termed mucoid conversion, which is mediated by gene mutations in mucA. The clinical significance of mucA gene mutation in non-CF obstructive diseases is not clear. We evaluated the factors for prognosis and the influence of mucA gene mutation on clinical outcomes among COPD patients with P. aeruginosa pneumonia.
This study prospectively enrolled COPD patients with P. aeruginosa pneumonia from November 2012 to December 2014 at two university hospitals. The clinical and laboratory data were collected for all patients. In addition, the mucA gene of P. aeruginosa isolates from COPD patients was analyzed.
There were 75 COPD patients with P. aeruginosa pneumonia. The APACHE II score and C-reactive protein/Albumin (CA) ratio at the time of P. aeruginosa pneumonia were independent predictive factor for mortality in COPD patients with P. aeruginosa pneumonia (odds ratio [OR] 1.25, 95% confidence intervals [CIs] 1.07-1.46, p = 0.004; and OR 1.06, 95% CIs 1.02-1.10, p = 0.003, respectively). In addition, mucA gene mutation of P. aeruginosa was independent predictors of mortality in COPD patients with P. aeruginosa pneumonia (OR 10.43, 95% CIs 1.53-70.90, p = 0.017).
Our results suggest that CA ratio and mucA gene mutation of P. aeruginosa could be used as predictors to identify COPD patients with P. aeruginosa pneumonia for poor prognosis.
S. J. Jeong, None