British Thoracic Society national bronchiectasis audit 2010 and 2011: Figure 1

Hill, Adam T.; Welham, Sally; Reid, Kerry; Bucknall, Christine

doi:10.1136/thoraxjnl-2012-201983

Cited by 43 publications

(50 citation statements)

References 2 publications

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“…Previous studies of bronchiectasis have focused on patients in a stable state and used only routine aerobic selective culture. In the present study, bacteria such as H. influenzae, P. aeruginosa, and S. pneumoniae were detected by culture at similar rates to those reported in these studies (8)(9)(10)(21)(22)(23)(24)(25). However, additional aerobic and anaerobic bacteria from a wide range of genera were also detected in high abundance, highlighting that complex polymicrobial communities exist within the lungs of these patients.…”

Section: Discussionsupporting

confidence: 66%

Lung Microbiota and Bacterial Abundance in Patients with Bronchiectasis when Clinically Stable and during Exacerbation

Tunney¹,

Einarsson²,

Wei³

et al. 2013

Am J Respir Crit Care Med

282

214

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Rationale: Characterization of bacterial populations in infectious respiratory diseases will provide improved understanding of the relationship between the lung microbiota, disease pathogenesis, and treatment outcomes. Objectives: To comprehensively define lung microbiota composition during stable disease and exacerbation in patients with bronchiectasis. Methods: Sputum was collected from patients when clinically stable and before and after completion of antibiotic treatment of exacerbations. Bacterial abundance and community composition were analyzed using anaerobic culture and 16S rDNA pyrosequencing. Measurements and Main Results: In clinically stable patients, aerobic and anaerobic bacteria were detected in 40 of 40 (100%) and 33 of 40 (83%) sputum samples, respectively. The dominant organisms cultured were Pseudomonas aeruginosa (n ¼ 10 patients), Haemophilus influenzae (n ¼ 12), Prevotella (n ¼ 18), and Veillonella (n ¼ 13). Pyrosequencing generated more than 150,000 sequences, representing 113 distinct microbial taxa; the majority of observed community richness resulted from taxa present in low abundance with similar patterns of phyla distribution in clinically stable patients and patients at the onset of exacerbation. After treatment of exacerbation, there was no change in total (P ¼ 0.925), aerobic (P ¼ 0.917), or anaerobic (P ¼ 0.683) load and only a limited shift in community composition. Agreement for detection of bacteria by culture and pyrosequencing was good for aerobic bacteria such as P. aeruginosa (k ¼ 0.84) but poorer for other genera including anaerobes. Lack of agreement was largely due to bacteria being detected by pyrosequencing but not by culture. Conclusions: A complex microbiota is present in the lungs of patients with bronchiectasis and remains stable through treatment of exacerbations, suggesting that changes in microbiota composition do not account for exacerbations.

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Section: Discussionsupporting

confidence: 66%

Lung Microbiota and Bacterial Abundance in Patients with Bronchiectasis when Clinically Stable and during Exacerbation

Tunney¹,

Einarsson²,

Wei³

et al. 2013

Am J Respir Crit Care Med

282

214

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“…Several reports describe the long-term use of inhaled antibiotics in ∼10% and of macrolides in ∼30% of all bronchiectasis patients [50][51][52]. Various inhaled antibiotics have been tested to reduce bacterial load from bronchiectasis patients' airways, and related symptoms and exacerbations, such as tobramycin [53,54], colistin [55], gentamicin [56] and aztreonam [57].…”

Section: Consensus Statements 1)mentioning

confidence: 99%

Research priorities in bronchiectasis: a consensus statement from the EMBARC Clinical Research Collaboration

et al. 2016

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Bronchiectasis is a disease of renewed interest in light of an increase in prevalence and increasing burden on international healthcare systems. There are no licensed therapies, and large gaps in knowledge in terms of epidemiology, pathophysiology and therapy. The European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) is a European Respiratory Society (ERS) Clinical Research Collaboration, funded by ERS to promote high-quality research in bronchiectasis. The objective of this consensus statement was to define research priorities in bronchiectasis. From 2014 to 2015, EMBARC used a modified Delphi process among European bronchiectasis experts to reach a consensus on 55 key research priorities in this field. During the same period, the European Lung Foundation collected 711 questionnaires from adult patients with bronchiectasis and their carers from 22 European countries reporting important research priorities from their perspective. This consensus statement reports recommendations for bronchiectasis research after integrating both physicians and patients priorities, as well as those uniquely identified by the two groups. Priorities identified in this consensus statement provide the clearest possible roadmap towards improving our understanding of the disease and the quality of care for patients with bronchiectasis. @ERSpublications EMBARC consensus statement identifies research priorities in bronchiectasis as determined by physicians and patients

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“…It is therefore not advised for use in this group of patients, and highlights the different pathophysiology in bronchiectasis, compared with CF-associated bronchiectasis. The mucolytics, for example carbocisteine and N-acetylcysteine, are widely used as evidenced by the BTS audit, but there are no controlled trials to demonstrate if this practice is beneficial [54].…”

Section: Inhaled Hyperosmolar Agents and Mucolyticsmentioning

confidence: 99%

Management of bronchiectasis in adults

2015

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Formerly regarded as a rare disease, bronchiectasis is now increasingly recognised and a renewed interest in the condition is stimulating drug development and clinical research. Bronchiectasis represents the final common pathway of a number of infectious, genetic, autoimmune, developmental and allergic disorders and is highly heterogeneous in its aetiology, impact and prognosis.The goals of therapy should be: to improve airway mucus clearance through physiotherapy with or without adjunctive therapies; to suppress, eradicate and prevent airway bacterial colonisation; to reduce airway inflammation; and to improve physical functioning and quality of life.Fortunately, an increasing body of evidence supports interventions in bronchiectasis. The field has benefited greatly from the introduction of evidence-based guidelines in some European countries and randomised controlled trials have now demonstrated the benefit of long-term macrolide therapy, with accumulating evidence for inhaled therapies, physiotherapy and pulmonary rehabilitation.This review provides a critical update on the management of bronchiectasis focussing on emerging evidence and recent randomised controlled trials. @ERSpublications Bronchiectasis is a rapidly developing field: review of recent RCTs and progress towards developing new therapies

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British Thoracic Society national bronchiectasis audit 2010 and 2011: Figure 1

Cited by 43 publications

References 2 publications

Lung Microbiota and Bacterial Abundance in Patients with Bronchiectasis when Clinically Stable and during Exacerbation

Lung Microbiota and Bacterial Abundance in Patients with Bronchiectasis when Clinically Stable and during Exacerbation

Research priorities in bronchiectasis: a consensus statement from the EMBARC Clinical Research Collaboration

Management of bronchiectasis in adults

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