Pseudomonas Resistance in Bronchiectasis Physiotherapy Patients

Title: Pseudomonas Resistance in Bronchiectasis Physiotherapy Patients
Author(s): C. Hayes, R. Keane, C. Egan, P. Branagan.
Institution: Beaumont Hospital, Dublin
Poster: Click to view poster
Category: CF and Pulmonary Infections
Abstract: Pseudomonas infection is associated with worsening FEV1 and increased hospitalisations in patients with bronchiectasis. Antimicrobial resistance worldwide contributes to this problem, and patients receiving multiple courses of antibiotics are particularly at risk. The aim of this study is to identify multi-drug resistance rates in the cohort of patients with difficult to clear secretions who were referred to the respiratory physiotherapy department for chest clearance techniques over a 3 year period.

Seventy four patients (43 female, average age 67) with confirmed bronchiectasis were identified. Eighteen patients (24%) had at least 1 growth of Pseudomonas in the last three years. Of these, 6 patients (33%) had resistant pseudomonas, requiring combination antibiotic therapy for outpatient treatment. These patients were older, with a higher number of previous exacerbations, and lower FEV1. These patients also required more frequent visits for chest physiotherapy.

Pseudomonas rates in this cohort are similar to pseudomonas rates seen in the overall bronchiectasis population. The resistance rates of 33% are concerning, but are in line with resistance levels seen elsewhere. Appropriate antimicrobial stewardship, exacerbation prevention strategies, and appropriate vaccinations are required to reduce the risks of development of pseudomonas resistance in these patients.