LUNG-FUNCTION IN BRONCHIECTASIS - THE INFLUENCE OF PSEUDOMONAS-AERUGINOSA

Sputum isolation of Pseudomonas aeruginosa (PA) is associated with ext ensive disease in bronchiectasis, It is not known, however, whether in fection with P. aeruginosa is the result or the cause of severe diseas e. We compared spirometry in patients with bronchiectasis before and a fter infection with P. aeruginosa, with that of patients infected by o ther organisms, All patients (n=12) with chronic colonization by P. ae ruginosa (PA group) were studied, These were compared with other patie nts with bronchiectasis with no isolations of P. aeruginosa (n=37, non -PA group). In the PA group, forced expiratory volume in one second (F EV1) and forced vital capacity (FVC) were lower than in the non-PA gro up, The PA group, however, also had lower values at the time of initia l colonization with P. aeruginosa than the current values for the non- PA group, Change in FEV1 and FVC over time was faster in the PA group than in the non-PA group, Reduction of FEV1 and FVC over time in the P A group prior to P. aeruginosa colonization was intermediate, not bein g statistically different from either value above. Our results confirm the association of chronic P. aeruginosa colonization with poor lung function, but conclude that patients with bronchiectasis who become co lonized by P. aeruginosa have poorer lung function when first colonize d than those colonized by other organisms, Decline in lung function is faster in those chronically colonized by P. aeruginosa than in those colonized by other organisms, It is not clear whether chronic P. aerug inosa colonization causes an accelerated decline in lung function or w hether it is simply a marker of those whose lung function is already d eclining rapidly.