TY - JOUR
T1 - Anti-Pseudomonas aeruginosa IgG antibodies and chronic airway infection in bronchiectasis
AU - Suarez-Cuartin, Guillermo
AU - Smith, Alex
AU - Abo-Leyah, Hani
AU - Rodrigo-Troyano, Ana
AU - Perea, Lidia
AU - Vidal, Silvia
AU - Plaza, Vicente
AU - Fardon, Thomas C.
AU - Sibila, Oriol
AU - Chalmers, James D.
PY - 2017/7/1
Y1 - 2017/7/1
N2 - © 2017 Background Identification of chronic Pseudomonas aeruginosa (PA) infection is important in the management of bronchiectasis, but requires repeated sputum sampling. We hypothesized that serum anti-PA IgG antibodies could diagnose chronic PA infection at a single visit. Methods Clinically stable bronchiectasis patients were studied prospectively. Chronic PA infection was defined as 2 or more positive sputum samples at least 3 months apart and/or failure to clear PA following eradication treatment. Baseline serum anti-PA IgG was determined by a validated ELISA kit. Results A total of 408 patients were included. Sixty of them (14.7%) had chronic PA infection and had higher anti-PA IgG levels (median 6.2 vs. 1.3 units, p < 0.001). Antibody levels showed direct significant correlations with exacerbation frequency, the bronchiectasis severity index and sputum inflammatory markers. Fifty-seven patients with chronic PA infection had a positive test, giving 95% sensitivity, 74.4% specificity and AUROC of 0.87. During follow-up, 38 patients had a new PA isolation. Eradication at 12 months was achieved in 89.5% of subjects with a negative antibody test and 15.8% of patients with a positive test. Conclusions Anti-PA IgG test is highly accurate to detect chronic PA infection in bronchiectasis patients. In addition, it may be a marker of disease severity and treatment response.
AB - © 2017 Background Identification of chronic Pseudomonas aeruginosa (PA) infection is important in the management of bronchiectasis, but requires repeated sputum sampling. We hypothesized that serum anti-PA IgG antibodies could diagnose chronic PA infection at a single visit. Methods Clinically stable bronchiectasis patients were studied prospectively. Chronic PA infection was defined as 2 or more positive sputum samples at least 3 months apart and/or failure to clear PA following eradication treatment. Baseline serum anti-PA IgG was determined by a validated ELISA kit. Results A total of 408 patients were included. Sixty of them (14.7%) had chronic PA infection and had higher anti-PA IgG levels (median 6.2 vs. 1.3 units, p < 0.001). Antibody levels showed direct significant correlations with exacerbation frequency, the bronchiectasis severity index and sputum inflammatory markers. Fifty-seven patients with chronic PA infection had a positive test, giving 95% sensitivity, 74.4% specificity and AUROC of 0.87. During follow-up, 38 patients had a new PA isolation. Eradication at 12 months was achieved in 89.5% of subjects with a negative antibody test and 15.8% of patients with a positive test. Conclusions Anti-PA IgG test is highly accurate to detect chronic PA infection in bronchiectasis patients. In addition, it may be a marker of disease severity and treatment response.
KW - Antibody
KW - Bronchiectasis
KW - Chronic infection
KW - Pseudomonas aeruginosa
U2 - 10.1016/j.rmed.2017.05.001
DO - 10.1016/j.rmed.2017.05.001
M3 - Article
VL - 128
SP - 1
EP - 6
JO - Respiratory Medicine
JF - Respiratory Medicine
SN - 0954-6111
ER -