Bacteria and viruses and clinical outcomes of asthma‐bronchiectasis overlap syndrome: A cohort study

Background Despite the high prevalence of co‐existing bronchiectasis and asthma (asthma‐bronchiectasis overlap syndrome [ABOS]), little is known regarding the dominant pathogens and clinical correlates. Objective To investigate the bacteria and viruses which differentially dominate in ABOS (includin...

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Published in:Clinical and translational allergy 2024-01, Vol.14 (1), p.e12331-n/a
Main Authors: Zhang, Xiao‐xian, He, Jia‐hui, Pan, Cui‐xia, He, Zhen‐feng, Li, Hui‐min, Lin, Zhen‐hong, Zhang, Xiao‐fen, Cen, Lai‐jian, Zhang, Ri‐lan, Shi, Ming‐xin, Guan, Wei‐jie
Format: Article
Language:English
Subjects:
Allergens
Allergies
Antibiotics
Asthma
asthma‐bronchiectasis overlap syndrome
atopy
Bacteria
Cohort analysis
exacerbation
Hay fever
Medical ethics
Neutrophils
Pathogens
Rhinitis
Spirometry
Streptococcus infections
Variables
Viruses
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Summary:Background Despite the high prevalence of co‐existing bronchiectasis and asthma (asthma‐bronchiectasis overlap syndrome [ABOS]), little is known regarding the dominant pathogens and clinical correlates. Objective To investigate the bacteria and viruses which differentially dominate in ABOS (including its subtypes) compared with bronchiectasis alone, and determine their relevance with bronchiectasis severity and exacerbations. Methods This was a prospective observational cohort study conducted between March 2017 and August 2023. We included 81 patients with ABOS and 107 patients with bronchiectasis alone. At steady‐state baseline, patients underwent comprehensive assessments and sputum collection for bacterial culture and viral detection (quantitative polymerase‐chain‐reaction). Patients were followed‐up to record exacerbation and spirometry. Results Patients with ABOS had significantly higher symptom burden and exacerbation frequency than those with bronchiectasis alone. Despite similar pathogen spectrum, the rate of bacteria–virus co‐detection increased less substantially at acute exacerbations (AE) onset than at steady‐state compared with bronchiectasis alone. Pathogenic bacteria (particularly Pseudomonas aeruginosa) were detected fairly common (exceeding 50%) in ABOS and were associated with greater severity of bronchiectasis when stable and conferred greater exacerbation risks at follow‐up. Viral but not bacterial compositions changed substantially at AE onset compared with clinical stability. Higher blood eosinophil count, moderate‐to‐severe bronchiectasis and non‐atopy were associated with higher odds of bacterial, but not viral, detection (all p 
ISSN:2045-7022
2045-7022
DOI:10.1002/clt2.12331