Impact of chronic Pseudomonas aeruginosa infection on health-related quality of life in Mycobacterium avium complex lung disease

Hirofumi Kamata,Kazuma Yagi,Yohei Funatsu,Tomoyasu Nishimura,Naoki Hasegawa,Shunsuke Uno,Tomoko Betsuyaku,Takanori Asakura,Shoji Suzuki,Ho Namkoong,Hiroshi Fujiwara,Yoshifumi Uwamino,Makoto Ishii,Satoshi Okamori

doi:10.1186/s12890-017-0544-x

Hirofumi Kamata, Kazuma Yagi + Show 12 more

Open Access

https://doi.org/10.1186/s12890-017-0544-x

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Abstract

BackgroundIn bronchiectasis patients, chronic Pseudomonas aeruginosa (PA) infection has been associated with worse health-related quality of life (HRQL), but little is known about Mycobacterium avium complex lung disease (MACLD) patients in this context. This study aimed to evaluate HRQL and investigate the impact of chronic PA infection in MACLD patients.MethodsThis cross-sectional study was conducted using the Registry of Prospective Cohort Study including MACLD patients. The 36-item Short-Form health survey (SF-36) and St. George’s Respiratory Questionnaire (SGRQ) were administered to assess clinical outcomes. Clinical variables included treatment and sputum culture status, pulmonary function tests, cavitary lesions, and modified Reiff scores on high-resolution computed tomography.ResultsThe study included 244 MACLD patients (median age, 68 years; 196 women), 19 of whom had chronic PA infection. Modified Reiff score was higher in patients with chronic infection than in those without (P = 0.028). Regarding SF-36 scores, physical functioning subscale scores were significantly lower in patients with chronic infection (P = 0.029). Additionally, SGRQ symptoms, impact, and total scores were significantly higher in patients with chronic infection. During analysis of covariance comparisons, SGRQ symptoms and impact scores were significantly higher for patients with chronic infection (P = 0.043 and 0.021, respectively).ConclusionsMACLD patients with chronic PA infection exhibited significantly higher SGRQ scores, indicating impaired HRQL. Chronic PA infection was significantly associated with the severity of bronchiectasis.

Highlights

In bronchiectasis patients, chronic Pseudomonas aeruginosa (PA) infection has been associated with worse health-related quality of life (HRQL), but little is known about Mycobacterium avium complex lung disease (MACLD) patients in this context
The current study aimed to evaluate HRQL via the 36-item Short-Form health survey (SF-36) and St. George’s Respiratory Questionnaire (SGRQ) to investigate the impact of chronic PA infection on MACLD patients
Patient characteristics and clinical features A total of 244 patients with MACLD were included in the study

Summary

Introduction

Chronic Pseudomonas aeruginosa (PA) infection has been associated with worse health-related quality of life (HRQL), but little is known about Mycobacterium avium complex lung disease (MACLD) patients in this context. Antimicrobial therapy for MAC lung disease (MACLD) for >12 months yields a success rate of approximately 75% [4], but high rates of recurrence have been reported after discontinuation of treatment [5]. Because of the increasing prevalence and chronicity of MACLD, as well as the limited data regarding antimicrobial therapies associated with potential adverse effects, to monitor the patient’s overall health status, patientreported outcome measures that represent healthrelated quality of life (HRQL) have become increasingly important for MACLD [6]. Most MACLD patients had bronchiectasis in high-resolution computed tomography (HRCT) studies [11, 12]

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