Bacterial colonization plays a crucial role in the pathogenesis of bronchiectasis, but the clinical significance of specific organisms like Haemophilus influenzae remains poorly understood. A recent retrospective study aimed to investigate the impact of H. influenzae colonization on bronchiectasis patients. This study was published in the journal BMC Pulmonary Medicine by Seo-Hee Yang and colleagues.
Bronchiectasis is characterized by irreversible dilatation of bronchi and recurrent respiratory infections. H. influenzae is among the common colonizers in bronchiectasis, but its effects on disease severity and outcomes are not well-established.
The retrospective study screened adult bronchiectasis patients from a tertiary referral center in South Korea over an 18-year period. Propensity score matching was employed to compare patients with and without H. influenzae colonization. Parameters assessed included bronchiectasis severity index, exacerbation rates, lung function, and mortality.
Key Findings
• Out of 4,453 bronchiectasis patients, 79 (1.8%) were colonized with H. influenzae.
•Following propensity score matching, 78 patients with H. influenzae colonization were compared with 154 non-colonizers.
• Patients colonized with H. influenzae exhibited a higher bronchiectasis severity index (median 6 vs. 4, p = 0.002) and more extensive radiographic involvement.
• Incidence of mild exacerbation without hospitalization was significantly higher in H. influenzae colonizers (adjusted incidence rate ratio 0.15, 95% CI 0.12-0.24).
• Lung function and mortality rates did not significantly differ between the two groups.
The study highlights that H. influenzae colonization in bronchiectasis patients is associated with increased disease severity and a higher incidence of mild exacerbations. However, it did not significantly impact lung function or mortality rates. These findings emphasize the importance of monitoring and managing patients with bronchiectasis, especially those colonized with H. influenzae, to prevent exacerbations and improve outcomes.
Reference:
Yang, S.-H., Song, M. J., Kim, Y. W., Kwon, B. S., Lim, S. Y., Lee, Y.-J., Park, J. S., Cho, Y.-J., Lee, J. H., Lee, C.-T., & Kim, H.-J. Understanding the effects of Haemophilus influenzae colonization on bronchiectasis: a retrospective cohort study. BMC Pulmonary Medicine,2024;24(1). https://doi.org/10.1186/s12890-023-02823-8