COPD Patients with Bronchiectasis Have More Bacterial Lung Infections Than Those Without It

People with chronic obstructive pulmonary disease and bronchiectasis (BE) have more bacterial lung infections, and infections that last longer, than COPD patients without bronchiectasis, a study indicates.

Thee findings may explain why BE aggravates COPD, the researchers said.

The study, “Exacerbations in COPD Patients with Bronchiectasis,” was published this month in the journal Medical Sciences.

Both COPD and BE are lung diseases. COPD is characterized by a reduction in airflow that makes breathing difficult. BE is characterized by a permanent widening of medium-sized airways, inflammation, chronic bacterial infection, and destruction of the walls of airways known as bronchi.

There is a clear association between BE and COPD known as the BE-COPD overlap syndrome (BCOS).

COPD exacerbations, or increases in the severity of the disease, are caused by bacterial infections in the lungs, and are termed bacterial exacerbations.

Researchers decided to compare the frequency and length of bacterial exacerbations in COPD patients with and without BE. They also wanted to compare the length of time patients were free of bacterial exacerbations, which scientists call exacerbation-free intervals.

They followed 54 COPD patients for 12 months, 27 who also had BE and 27 who did not.

The team recorded 151 exacerbations during the year. One hundred twenty-three, or 81.4%, were bacterial exacerbations that had to be treated with antibiotics. Sixty-seven, or 54.5%, of the 123 cases involved COPD patients with BE. Fifty-six, or 45.5%, involved COPD patients without BE.

Researchers also found that the average number of bacterial exacerbations was higher in the group with both COPD and BE.

In addition, the average length of the exacerbations was 6.9 days in COPD patients with BE, versus 5.7 in patients without BE. And the average exacerbation-free interval in COPD patients with BE was considerably shorter — 56.4 days — than the 672. days in COPD patients without BE.

“The most common cause of COPD exacerbations is believed to be bacterial respiratory infection,” the researchers wrote. “One of the reasons for more frequent exacerbations in COPD patients may be due to the coexisting BE in these patients… Our findings indicated a significantly higher mean number of exacerbations, and a significantly higher mean duration, as well as a significantly shorter exacerbation-free interval in COPD patients with BE than in COPD patients without BE.

“Our findings support the theory that early identification of patients with COPD and BE would be an important advance, as it will provide opportunities to start an appropriate treatment,” the team concluded.