Influence of microbial contamination of the bronchi in the association with Pseudomonas aeruginosa on the course of bronchiectatic disease (clinical observation)

Abstract

The article presents a clinical observation of a young patient with severe bronchiectatic disease (BED), bronchoobstructive syndrome and chronic infection of Pseudomonas aeruginosa in аssociation with multiple microbial contamination of the bronchi and drug resistance.

Complaints, anamnesis of the disease are described, the results of laboratory and instrumental methods of research, including the dynamics of disease progression according to computed tomography of the lungs, as well as the treatment of the patient are clearly presented.

Possible etiological factors of BED in the patient, both acquired (recurrent pneumonia, allergic bronchopulmonary aspergillosis, tuberculosis, immunodeficiency states, inhalation of toxic gases/substances, diffuse connective tissue diseases) and congenital, given the young age and rapid progression of the disease (cystic fibrosis, Yung syndrome, primary ciliary dyskinesia syndrome, including Cartagener syndrome, α1-antitrypsin deficiency), are considered in detail.

Adverse factors that could aggravate the course of BEB were analyzed: multiple microbial contamination of the bronchi, including P. aeruginosa with the formation of drug resistance; smoking; low body mass index; persistent bronchial obstruction; frequent exacerbations; prevalence of the process; formation of the pulmonary heart. The severity index of BED (proposed in 2014 by European experts) was calculated.

The treatment of the patient was analyzed and compared with the international clinical recommendations of the European respiratory society "Bronchiectasis in adult patients", published in 2017.

Conclusion. On a clinical example demonstrates the negative impact of P. aeruginosa in association with multiple microbial contamination of the bronchi on the course of BED. This indicates the need for regular sputum culture in patients with BED for early detection of pathogenic flora and monitoring of bacterial infection, as well as timely eradication of antibacterial therapy, in the case of P. aeruginosa.

Keywords:bronchiectatic disease, bronchiectasis, Pseudomonas aeruginosa, treatment, antibacterial therapy

Funding. The study had no sponsor support.

Conflict of interests. The authors declare no conflict of interests.

For citation: Fomina K.A., Makoeva L.D., Arkad'eva G.V., Serebryakova Z.V., Danilin A.G., Anpilogova N.V., Kirpikova I.M., Lebedeva A.A. Influence of microbial contamination of the bronchi in the association with Pseudomonas aeruginosa on the course of bronchiectatic disease (clinical observation). Infektsionnye bolezni: novosti, mneniya, obuchenie [Infectious Diseases: News, Opinions, Training]. 2020; 9 (2): 132-9. DOI: 10.33029/2305-3496-2020-9-2-132-139 (in Russian)

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CHIEF EDITOR
Aleksandr V. Gorelov
Academician of the Russian Academy of Sciences, MD, Head of Infection Diseases and Epidemiology Department of the Scientific and Educational Institute of Clinical Medicine named after N.A. Semashko ofRussian University of Medicine, Ministry of Health of the Russian Federation, Professor of the Department of Childhood Diseases, Clinical Institute of Children's Health named after N.F. Filatov, Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Deputy Director for Research, Central Research Institute of Epidemiology, Rospotrebnadzor (Moscow, Russian Federation)

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