Epidemiology of bronchiectasis at a single center in Japan: a retrospective cohort study
Abstract Background The characteristics of bronchiectasis (BE) in Asia, including Japan, remain largely unknown. We aimed to provide insights into the clinical characteristics and treatment outcomes of BE, especially regarding nontuberculous mycobacteria (NTM) infection and its poorly understood imp...
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2024-10-01
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| Online Access: | https://doi.org/10.1186/s12890-024-03337-7 |
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| author | Kazuki Hashimoto Yuko Abe Kiyoharu Fukushima Takayuki Niitsu Sho Komukai Satoshi Miyamoto Takuro Nii Takanori Matsuki Noriyuki Takeuchi Kozo Morimoto Hiroshi Kida |
| author_facet | Kazuki Hashimoto Yuko Abe Kiyoharu Fukushima Takayuki Niitsu Sho Komukai Satoshi Miyamoto Takuro Nii Takanori Matsuki Noriyuki Takeuchi Kozo Morimoto Hiroshi Kida |
| author_sort | Kazuki Hashimoto |
| collection | DOAJ |
| description | Abstract Background The characteristics of bronchiectasis (BE) in Asia, including Japan, remain largely unknown. We aimed to provide insights into the clinical characteristics and treatment outcomes of BE, especially regarding nontuberculous mycobacteria (NTM) infection and its poorly understood impact on prognosis. We also aimed to clarify the effect of long-term macrolide antibiotic use in patients with BE, who had no history of exacerbations. Methods In this single-center, retrospective study, the medical records of patients who satisfied the BE criteria between January 1, 2012, and August 31, 2023, were reviewed. Severe exacerbations and mortality during the observation period were recorded. Baseline characteristics and overall survival of patients with and without NTM infection, and factors influencing the time to the first exacerbation and death were analyzed. Additionally, the effects of long-term macrolide antibiotic use in patients without a history of severe exacerbations were estimated. Results In a cohort of 1044 patients with BE, the rate of severe exacerbation was 22.3%, with mortality rates of 3.2% over 3 years. Notably, the high prevalence of NTM infection (n = 410, 39.3%) in this cohort was distinctive. NTM infection was not associated with either the time to first severe exacerbation (p = 0.5676, adjusted hazard ratio = 1.11) or mortality (p = 0.4139, adjusted hazard ratio = 0.78). Compared with the NTM group, the non-NTM group had a higher proportion of elevated inflammatory markers, with significant differences in C-reactive protein levels (p = 0.0301) and blood neutrophil counts (p = 0.0273). Pseudomonas aeruginosa colonization was more frequent in the non-NTM group (p = 0.0003). Among patients with non-NTM infection and without a history of exacerbation in the past 2 years, 38.2% received long-term macrolide antibiotics that did not invariably prolong the time to first severe exacerbation (p = 0.4517, IPW p = 0.3555). Conclusions This study highlights BE epidemiology in Japan, noting that the presence of NTM infection may not necessarily worsen the prognostic outcomes and advising caution in the casual use of macrolides for milder cases without a history of exacerbations. Clinical trial registration UMIN Clinical Trials Registry Number: UMIN000054726 (Registered on 21 June 2024). |
| format | Article |
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| publishDate | 2024-10-01 |
| publisher | BMC |
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| series | BMC Pulmonary Medicine |
| spelling | doaj-art-35205b0c2fa54eaf84695e721537ce732025-08-20T02:11:23ZengBMCBMC Pulmonary Medicine1471-24662024-10-0124111110.1186/s12890-024-03337-7Epidemiology of bronchiectasis at a single center in Japan: a retrospective cohort studyKazuki Hashimoto0Yuko Abe1Kiyoharu Fukushima2Takayuki Niitsu3Sho Komukai4Satoshi Miyamoto5Takuro Nii6Takanori Matsuki7Noriyuki Takeuchi8Kozo Morimoto9Hiroshi Kida10Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of MedicineDepartment of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of MedicineDepartment of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of MedicineDepartment of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of MedicineDepartment of Biomedical Statistics, Graduate School of Medicine, Osaka UniversityDepartment of Respiratory Medicine, National Hospital Organization, Osaka Toneyama Medical CentreDepartment of Respiratory Medicine, National Hospital Organization, Osaka Toneyama Medical CentreDepartment of Respiratory Medicine, National Hospital Organization, Osaka Toneyama Medical CentreDepartment of Radiology, National Hospital Organization, Osaka Toneyama Medical CentreRespiratory Disease Center, Fukujuji Hospital, Anti-Tuberculosis AssociationDepartment of Respiratory Medicine, National Hospital Organization, Osaka Toneyama Medical CentreAbstract Background The characteristics of bronchiectasis (BE) in Asia, including Japan, remain largely unknown. We aimed to provide insights into the clinical characteristics and treatment outcomes of BE, especially regarding nontuberculous mycobacteria (NTM) infection and its poorly understood impact on prognosis. We also aimed to clarify the effect of long-term macrolide antibiotic use in patients with BE, who had no history of exacerbations. Methods In this single-center, retrospective study, the medical records of patients who satisfied the BE criteria between January 1, 2012, and August 31, 2023, were reviewed. Severe exacerbations and mortality during the observation period were recorded. Baseline characteristics and overall survival of patients with and without NTM infection, and factors influencing the time to the first exacerbation and death were analyzed. Additionally, the effects of long-term macrolide antibiotic use in patients without a history of severe exacerbations were estimated. Results In a cohort of 1044 patients with BE, the rate of severe exacerbation was 22.3%, with mortality rates of 3.2% over 3 years. Notably, the high prevalence of NTM infection (n = 410, 39.3%) in this cohort was distinctive. NTM infection was not associated with either the time to first severe exacerbation (p = 0.5676, adjusted hazard ratio = 1.11) or mortality (p = 0.4139, adjusted hazard ratio = 0.78). Compared with the NTM group, the non-NTM group had a higher proportion of elevated inflammatory markers, with significant differences in C-reactive protein levels (p = 0.0301) and blood neutrophil counts (p = 0.0273). Pseudomonas aeruginosa colonization was more frequent in the non-NTM group (p = 0.0003). Among patients with non-NTM infection and without a history of exacerbation in the past 2 years, 38.2% received long-term macrolide antibiotics that did not invariably prolong the time to first severe exacerbation (p = 0.4517, IPW p = 0.3555). Conclusions This study highlights BE epidemiology in Japan, noting that the presence of NTM infection may not necessarily worsen the prognostic outcomes and advising caution in the casual use of macrolides for milder cases without a history of exacerbations. Clinical trial registration UMIN Clinical Trials Registry Number: UMIN000054726 (Registered on 21 June 2024).https://doi.org/10.1186/s12890-024-03337-7BronchiectasisMacrolidesNontuberculous mycobacteriaTB |
| spellingShingle | Kazuki Hashimoto Yuko Abe Kiyoharu Fukushima Takayuki Niitsu Sho Komukai Satoshi Miyamoto Takuro Nii Takanori Matsuki Noriyuki Takeuchi Kozo Morimoto Hiroshi Kida Epidemiology of bronchiectasis at a single center in Japan: a retrospective cohort study BMC Pulmonary Medicine Bronchiectasis Macrolides Nontuberculous mycobacteria TB |
| title | Epidemiology of bronchiectasis at a single center in Japan: a retrospective cohort study |
| title_full | Epidemiology of bronchiectasis at a single center in Japan: a retrospective cohort study |
| title_fullStr | Epidemiology of bronchiectasis at a single center in Japan: a retrospective cohort study |
| title_full_unstemmed | Epidemiology of bronchiectasis at a single center in Japan: a retrospective cohort study |
| title_short | Epidemiology of bronchiectasis at a single center in Japan: a retrospective cohort study |
| title_sort | epidemiology of bronchiectasis at a single center in japan a retrospective cohort study |
| topic | Bronchiectasis Macrolides Nontuberculous mycobacteria TB |
| url | https://doi.org/10.1186/s12890-024-03337-7 |
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