AbstractIntroduction and Objectives
It is well established in patients with CF mPA indicates chronic infection and is associated with increased morbidity and mortality. Mucoid PA can be isolated in people with non-CF lung disease but to-date no study has systematically characterised these patients. The aim of this study was to characterise and evaluate the significance of mucoid strain in a large non CF population.Methods
This study retrospectively examined the demography, clinical diagnoses and survival, of patients without CF with an initial isolate of mPA from their respiratory samples, between January 2008 and December 2010, in Leeds. Data were obtained from the microbiology and radiology databases, and from the clinical notes. Ethical approval was obtained.Results
A total of 170 patients isolated mPA in sputum for the first time during the study period. The median (range) age was 73 (22–99) years and 54% were female. 46% of patients had samples obtained during an in-patient stay. 21% of the patients had never seen a respiratory physician. The majority of patients had a diagnosis of bronchiectasis (See Abstract P169 figure 1). A third of patents had isolated non-mucoid PA prior to isolating mPA. 62% of the patients had a subsequent respiratory sample analysed and the majority continued to grow mPA. 24 patients also grew Methicillin-resistant Staphylococcus aureus (MRSA) from their sputum. The median age (range) of death was 78 (40–95) years. The cumulative survival was 50% at 3 years after isolating mPA. Factors associated with increased mortality included co-isolation of MRSA, no previous respiratory review, isolating mPA during in-patient care and absence of bronchiectasis (p<0.05).Conclusions
Mucoid P aeruginosa isolated from the sputum of patients without CF may persist and is associated with high mortality. The underlying respiratory diagnosis of patients isolating mPA includes a range of respiratory diseases. There may be an opportunity to eradicated P aeruginosa in patients who grow non-mucoid PA before the emergence of mPA.