Risk factors for Pseudomonas aeruginosa isolation in chronic obstructive pulmonary disease: a systematic review and meta-analysis.

IF 2.6 3区医学 Q2 RESPIRATORY SYSTEM BMC Pulmonary Medicine Pub Date : 2024-10-18 DOI:10.1186/s12890-024-03309-x

Yuyu Zhang, Nini Zhang, Tingting Li, Lanrui Jing, Yu Wang, Wei Ge

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Abstract

Background: Pseudomonas aeruginosa (PA) isolation in patients with chronic obstructive pulmonary disease (COPD) has been associated with a poor prognosis. This meta-analysis aimed to determine significant risk factors for PA isolation among patients with COPD.

Methods: A systematic literature retrieval from PubMed, Embase, Web of Science and China National Knowledge Infrastructure (CNKI) was conducted, including studies from January 2003 to September 2024. Case-control and cohort studies exploring the risk factors for PA isolation in patients with COPD were included in this analysis. A random-effects model was applied to estimate the pooled adjusted odds ratio (paOR) or hazard ratio (paHR) with the corresponding 95% confidence intervals (CI).

Results: Thirteen eligible studies with a total of 25,802 participants were included in this meta-analysis. Prior systemic steroid therapy (paOR: 2.67; 95% CI: 1.29-5.53; P = 0.008), previous antibiotic treatment (paOR: 2.83; 95% CI: 1.14-6.97; P = 0.02), high "Body mass index, airflow Obstruction, Dyspnea, Exercise capacity" (BODE) index (paOR: 4.13; 95% CI: 1.67-10.23; P = 0.002), 6-min walking distance (6MWD) < 250 m (paOR: 4.27; 95% CI: 2.59-7.01; P < 0.001), COPD assessment test (CAT) score > 20 points (paOR: 2.49; 95% CI: 1.46-4.23; P = 0.001), hypoproteinemia (paOR: 2.62; 95%CI: 1.32-5.19; P = 0.006), hospitalizations in the previous year (paOR: 3.74; 95%CI: 1.22-11.49; P = 0.021), Bronchiectasis (paOR = 4.81; 95% CI: 3.66-6.33; P < 0.001) and prior PA isolation (paOR: 16.39; 95% CI: 7.65-35.10; P < 0.001) were associated with PA isolation in patients with COPD.

Conclusions: Our study identified nine risk factors associated with an increased risk of PA isolation in COPD patients. These findings are significant for the early identification of patients at risk for PA isolation, which might contribute to reducing mortality and improving clinical outcomes.

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慢性阻塞性肺病铜绿假单胞菌分离的风险因素：系统回顾和荟萃分析。

背景：慢性阻塞性肺疾病（COPD）患者铜绿假单胞菌（PA）分离与不良预后有关。这项荟萃分析旨在确定慢性阻塞性肺病患者中铜绿假单胞菌分离的重要风险因素：从 PubMed、Embase、Web of Science 和中国国家知识基础设施（CNKI）中进行了系统的文献检索，包括 2003 年 1 月至 2024 年 9 月期间的研究。本次分析纳入了探讨慢性阻塞性肺病患者PA隔离风险因素的病例对照和队列研究。采用随机效应模型来估算汇总调整后的几率比（paOR）或危险比（paHR）以及相应的95%置信区间（CI）：本次荟萃分析共纳入了 13 项符合条件的研究，共有 25802 名参与者。曾接受全身类固醇治疗（paOR：2.67；95% CI：1.29-5.53；P = 0.008）、曾接受抗生素治疗（paOR：2.83；95% CI：1.14-6.97；P = 0.02）、"体重指数、气流阻塞、呼吸困难、运动能力"（BODE）指数高（paOR：4.13；95% CI：1.67-10.23；P = 0.002）、6 分钟步行距离（6MWD）20 分（paOR：2.49；95% CI：1.46-4.23；P = 0.001）、低蛋白血症（paOR：2.62；95%CI：1.32-5.19；P = 0.006）、前一年住院（paOR：3.74；95%CI：1.22-11.49；P = 0.021）、支气管扩张（paOR = 4.81；95% CI：3.66-6.33；P 结论：我们的研究发现了九个与支气管扩张相关的风险因素，它们分别是：（1）支气管扩张；（2）支气管扩张；（3）支气管扩张；（4）支气管扩张；（5）支气管扩张；（6）支气管扩张；（7）支气管扩张；（8）支气管扩张；（9）支气管扩张：我们的研究发现了与慢性阻塞性肺病患者 PA 隔离风险增加相关的九个风险因素。这些发现对早期识别有 PA 隔离风险的患者意义重大，可能有助于降低死亡率和改善临床预后。

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来源期刊

BMC Pulmonary Medicine RESPIRATORY SYSTEM-

CiteScore

4.40

自引率

3.20%

发文量

423

审稿时长

6-12 weeks

期刊介绍： BMC Pulmonary Medicine is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of pulmonary and associated disorders, as well as related molecular genetics, pathophysiology, and epidemiology.