Mortality and exacerbations associated with Stenotrophomonas maltophilia in chronic obstructive pulmonary disease. A regional cohort study of 22,689 outpatients

Christian Rønn*, Peter Kamstrup, Josefin Eklöf, Louise Lindhardt Toennesen, Jonas Bredtoft Boel, Christian Ostergaard Andersen, Ram Benny Dessau, Jon Torgny Wilcke, Pradeesh Sivapalan, Charlotte Suppli Ulrik, Jens Ulrik Stæhr Jensen

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

3 Citationer (Scopus)
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Abstract

Objectives
The clinical significance of Stenotrophomonas maltophilia in patients with COPD is poorly understood. We aimed to determine whether a lower respiratory tract culture positive for S. maltophilia in COPD patients was independently associated with increased risk of death and hospitalisation for exacerbation of COPD.

Methods
An observational cohort study following outpatients with COPD in Eastern Denmark between 2010 and 2018, with a follow-up period of five years. Presence of S. maltophilia was treated as a time-varying exposure, where patients were considered exposed at the time of the first isolation of S. maltophilia from the lower respiratory tract. The hazard ratio (HR) of death and hospitalisation for acute exacerbations of COPD was assessed using a Cox proportional hazards regression.

Results
Of the total 22,689 patients 459 (2.0%) had a lower respiratory sample positive for S. maltophilia. A total of 7,649 deaths (S. maltophilia positive: 243 (52.9%) and S. maltophilia negative: 7,406 (34.4%)) and 24,912 hospitalisations for exacerbation of COPD (S. maltophilia positive: 1,100 in 459 patients and S. maltophilia negative: 23,821 in 22,230 patients) were registered during the study period. We found that a lower respiratory tract culture positive for S. maltophilia was associated with both increased mortality: HR 3.3 (95% CI 2.6–4.3), and hospitalisation for exacerbation of COPD: HR 3.4 (95% CI 2.8–4.1).

Conclusions
A lower respiratory tract culture positive for S. maltophilia in COPD patients was associated with a substantially increased mortality and hospitalisation for exacerbation of COPD. Randomised controlled trials are proposed to determine whether S. maltophilia should be the target of antibiotic treatment.
OriginalsprogEngelsk
Artikelnummer232
TidsskriftRespiratory research
Vol/bind24
Udgave nummer1
Antal sider8
ISSN1465-9921
DOI
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
The study was financed by grants from the Novo Nordisk Foundation (No. NNF20OC0060657). The funding sources had no influence on study design, data collection, analysis, or reporting of data.

Publisher Copyright:
© 2023, BioMed Central Ltd., part of Springer Nature.

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