Eradication Of Pseudomonas Aeruginosa Within The Baseline Dataset Of The German Bronchiectasis Registry Prognosis

Background: Bronchiectasis patients infected with Pseudomonas aeruginosa (PA) have higher morbidity, mortality and lower quality of life. Therefore, eradication in an early state of infection is recommended by guidelines, even if scientific evidence is missing. Methods: We investigated the prevalence of PA eradication within the baseline dataset of the German Bronchiectasis Registry PROGNOSIS and further characterized the patients who received eradication treatment. Results: Until September 2019, 1338 patients were recruited in 38 centers. Analysis of the first 1000 validated datasets showed an average age of 59±16 yrs. (59% female; 55% never-smokers) and median annual exacerbation rate of 1 (0-3). In 75% (n=753) of all patients at least one microbiological culture was obtained within the last 12 months, of those PA was isolated in 38% (n=285). In 70,7% (n=249) of all patients who ever had a positive PA culture, an eradication attempt was made. Eradication attempts differ between the levels of health care (university hospital n=171, 80,7%, private practice n=38, 62,3%, lung clinic n=40, 76,9%, p=0,012). In the group of patients who received an eradication attempt 46,6% (n=111) were ever treated with inhaled antibiotics. Patients who ever cultured PA and received an eradication attempt had a lower ppFEV1 (59,03% vs 67,07%) and experienced more pulmonary exacerbations (2,61 vs 2,08, p=0,015) and hospital admissions (1,24 vs 0,95 p=0,001). Conclusions: In bronchiectasis PA is the most relevant pathogen. Depending on the healthcare level there is no close sputum surveillance for PA. Further studies to investigate PA eradication are warrant.