Diagnóstico y tratamiento de las bronquiectasias

Vendrell, Montserrat; Gracia, Javier de; Olveira, Casilda; Martı́nez, Miguel Ángel; Girón, Rosa; Máiz, Luís; Cantón, Rafael; Coll, Ramón; Escribano, Amparo; Solé, Amparó

doi:10.1157/13128330

Cited by 197 publications

(82 citation statements)

References 47 publications

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“…According to the recommendations of the Spanish Society of Pulmonology and Thoracic Surgery, the causes ruled out in idiopathic bronchiectasis were as follows: immune deficiencies with evidence of defective antibody production, gastroesophageal reflux disease, allergic bronchopulmonary aspergillosis, mycobacterial infection, CF, primary ciliary dyskinesia, and α1-antitrypsin deficiency [9]. Patients with allergic bronchopulmonary aspergillosis (n = 4) [10] were excluded because they comprise a subgroup that differs from patients with other causes of non-CF bronchiectasis in terms of the prevalence and pathogenic significance of Aspergillus colonization.…”

Section: Methodsmentioning

confidence: 99%

Prevalence and Factors Associated with Isolation of Aspergillus and Candida from Sputum in Patients with Non-Cystic Fibrosis Bronchiectasis

et al. 2015

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Background: Information on the role of fungi in non-cystic fibrosis (CF) bronchiectasis is lacking. Objectives: Our aim was to determine the prevalence of and factors associated with the isolation and persistence of fungi from sputum in these patients. Methods: We performed a multicenter observational study comprising adult patients with non-CF bronchiectasis. Persistence of Aspergillus spp. and Candida albicans was defined as the presence of ≥2 positive sputum cultures taken at least 6 months apart within a period of 5 years. Results: A total of 252 patients (62.7% women with a mean ± SD age of 55.3 ± 16.7 years) were included in the study. All patients had at least 1 sputum sample cultured for fungi, with a mean ± SD of 7 ± 6 cultures per patient. Eighteen (8.7%) and 71 (34.5%) patients had persistent positive cultures for Aspergillus spp. and C. albicans, respectively. Patients with persistence of Aspergillus spp. and C. albicans were older and had more daily purulent sputum. In addition, patients with persistent C. albicans had worse postbronchodilator forced expiratory volume in the first second (FEV₁), more frequent cystic bronchiectasis, and more hospital-treated exacerbations. They were also more frequently treated with long-term antibiotics. Multivariate analysis showed that daily purulent sputum (OR = 3.75, p = 0.045) and long-term antibiotics (OR = 2.37, p = 0.005) were independently associated with persistence of Aspergillus spp. and C. albicans, respectively. Conclusions: Isolation and persistence of Aspergillus spp. and C. albicans are frequent in patients with non-CF bronchiectasis. Daily purulent sputum and chronic antibiotic treatment were associated with persistence of Aspergillus spp. and C. albicans, respectively.

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Section: Methodsmentioning

confidence: 99%

Prevalence and Factors Associated with Isolation of Aspergillus and Candida from Sputum in Patients with Non-Cystic Fibrosis Bronchiectasis

et al. 2015

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“…One of the proposed theories suggests that this is because inflammatory mediators change from the resected intestine to the lung due to their common embryological origin [52]. In some cases, treatment with inhaled and oral glucocorticosteroids has been effective, including their instillation via bronchoalveolar lavage [42], but there is insufficient evidence to prescribe this treatment routinely [1,2].…”

Section: Inflammatory Bowel Disease (Ibd)mentioning

confidence: 99%

“…These include immunodeficiencies with antibody production deficiency, ABPA, primary ciliary dyskinesia, gastroesophageal reflux disease, mycobacterial infection, alpha-1 antitrypsin deficiency and CF [1]. Figure 1 summarises the proposed algorithm for addressing the aetiologic diagnosis [1,2]. …”

Section: Approaches To Aetiological Diagnosismentioning

confidence: 99%

“…These changes are a result of very diverse pulmonary or systemic diseases, which can influence the course of the disease. Therefore, aetiological investigation is one of the key aspects in the management of patients with bronchiectasis [1,2].…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, it is important to identify the aetiological cause of the bronchiectasis for a proper management. Current guidelines recommendations for the aetiolology of bronchiectasis include an extensive laboratory and instrumental workup, as well as lung function tests and microbiological evaluation [1,2]. The aim of this article is to review the main diseases associated with bronchiectasis in order to simplify the process of the aetiological diagnosis and therefore to help improving patient management when a treatable or modifiable cause is identified.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic challenges of bronchiectasis

Suárez-Cuartín

Chalmers

Sibila

2016

Respiratory Medicine

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Bronchiectasis is a condition of increasing incidence and prevalence around the world.Many different diseases have been associated with bronchiectasis, and their treatment can differ widely. Recent guidelines have helped to approach aetiological diagnosis but it is still a complex process. Identifying the cause of the bronchiectasis may determine a change in the treatment of a large group of subjects. That is one of the main reasons why the aetiological diagnosis is crucial in the proper management of bronchiectasis patients.Postinfectious bronchiectasis is the most frequent entity among different studies, but a high percentage of cases still remain without a clear aetiology. Bronchiectasis related to allergic bronchopulmonary aspergillosis (ABPA), immunodeficiencies with antibody production deficiency, primary ciliary dyskinesia, cystic fibrosis and alpha-1-antitrypsin deficiency, among others, require a specific management that may improve quality of life and prognosis in a large group of individuals. Therefore, the aim of this article is to review the main bronchiectasis related diseases and to simplify the aetiological diagnosis, in order to improve the management of bronchiectasis patients, especially in those where a specific treatment is available.

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Pseudomonas aeruginosa and Bronchiectasis

Soyza

Winstanley

2017

Bronchiectasis

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Diagnóstico y tratamiento de las bronquiectasias

Cited by 197 publications

References 47 publications

Prevalence and Factors Associated with Isolation of <b><i>Aspergillus</i></b> and <b><i>Candida </i></b>from Sputum in Patients with Non-Cystic Fibrosis Bronchiectasis

Prevalence and Factors Associated with Isolation of <b><i>Aspergillus</i></b> and <b><i>Candida </i></b>from Sputum in Patients with Non-Cystic Fibrosis Bronchiectasis

Diagnostic challenges of bronchiectasis

Pseudomonas aeruginosa and Bronchiectasis

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