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  • Benny Miles posted an update 3 years, 1 month ago

    Bronchiectasis often occurs in patients who have systemic diseases or other underlying associated conditions. The two basic pathogenic factors are airway obstruction and bacterial infection in the bronchial tree, leading to bacterial colonization of the bronchial mucosa and subsequent progressive lung damage.[13] A history of previous severe lower respiratory tract infections due to bacterial and viral pneumonia, pertussis or tuberculosis should be sought in all patients with bronchiectasis. Where possible, the temporal relationship of the identified infections with the onset of chronic respiratory symptoms should be determined.[1] Thirty-four (29%) subjects GUCY1B3 in the present study had a past history of pulmonary tuberculosis. It has been suggested that all children and adults with bronchiectasis should have an assessment of lower respiratory tract microbiology.[1] Understanding the local spectrum of lower respiratory Sepantronium Bromide research buy bacteriology among patients with bronchiectasis will help in choosing the appropriate empirical therapy, pending culture results. P. aeruginosa was the most common isolate (46%) in our study, a finding also noted in other studies.[11,13,14] Other studies have shown H. influenzae to be the most commonly isolated pathogen.[15,16] The differences could be due to the varied distribution of organisms in different geographical locations. Patients infected with P. aeruginosa are known to experience a more accelerated decline in lung function selleck kinase inhibitor and more frequent exacerbations than those infected with other organisms.[5] A similar observation was made in the present study with patients infected with P. aeruginosa having a higher number of exacerbations (p: 0.008) and a prolonged hospital stay (p: 0.03). Spirometry (FVC and FEV1) also demonstrated a significant difference (p: < 0.05) in the Pseudomonas versus non-pseudomonas group. HRCT is considered to be the best investigation for bronchiectasis patients to determine the involvement of different lobes of the lung with precision. In the present study, HRCT has revealed the increased severity of the disease based on the lobes of the lung involved in patients having P. aeruginosa infection (p: 0.001), as compared to the non-pseudomonas group. Although the isolates of P. aeruginosa were found to be sensitive to the antibiotics tested, most of them were mucoid strains. Once acquired, P. aeruginosa (especially the mucoid type) is difficult to eradicate from bronchiectasis and cystic fibrosis patients.[14] Prompt eradication treatment at the very onset of infection prior to its transition to a mucoid variant would seem advantageous.[17] Adequate antibiotic therapy, including a combination dosage, modes of delivery, and duration of therapy should be given due consideration.