TITLE Pseudomonas aeruginosa in patients hospitalized for COPD exacerbation. A prospective study

word count: 224 words Word count for text: 3005 Abstract Background. Risk factors for Pseudomonas aeruginosa (PA) isolation in patients hospitalized for COPD exacerbation remain controversial. The aim of our study was to determine the incidence and risk factors for PA isolation in sputum at hospital admission in a prospective cohort of patients with AECOPD. Methods. We prospectively studied all patients with COPD exacerbation admitted to our hospital between June 2003 and September 2004. Suspected predictors of PA isolation were studied. Spirometric and 6 minute walking test were performed 1 month after discharge. High-resolution computed tomography (HRCT) was performed in a randomized manner with 1 of every 2 patients to quantify the presence and extent of bronchiectasis. Patients were followed up during the subsequent year for hospital readmissions. Results. A total of 188 patients were included, of whom 31 (16.5%) had PA in sputum at initial admission. BODE index (OR: 2.18; CI 95%: 1.26-3.78; p=0.005), admissions in the previous year (OR: 1.65; CI 95%: 1.13-2.43; p=0.005), systemic steroid treatment (OR: 14.7; CI 95%: 2.28-94.8; p=0.01), and previous isolation of PA (OR: 23.1; CI 95%: 5.794.3; p<0.001) were associated with PA isolation. No relationship was seen between bronchiectasis in HRCT and antibiotic use in the previous 3 months. Conclusions. PA in sputum at hospital admission is more frequent in patients with poorer scoring on the BODE index, previous admissions, oral corticosteroids and prior isolation of PA.Background. Risk factors for Pseudomonas aeruginosa (PA) isolation in patients hospitalized for COPD exacerbation remain controversial. The aim of our study was to determine the incidence and risk factors for PA isolation in sputum at hospital admission in a prospective cohort of patients with AECOPD. Methods. We prospectively studied all patients with COPD exacerbation admitted to our hospital between June 2003 and September 2004. Suspected predictors of PA isolation were studied. Spirometric and 6 minute walking test were performed 1 month after discharge. High-resolution computed tomography (HRCT) was performed in a randomized manner with 1 of every 2 patients to quantify the presence and extent of bronchiectasis. Patients were followed up during the subsequent year for hospital readmissions. Results. A total of 188 patients were included, of whom 31 (16.5%) had PA in sputum at initial admission. BODE index (OR: 2.18; CI 95%: 1.26-3.78; p=0.005), admissions in the previous year (OR: 1.65; CI 95%: 1.13-2.43; p=0.005), systemic steroid treatment (OR: 14.7; CI 95%: 2.28-94.8; p=0.01), and previous isolation of PA (OR: 23.1; CI 95%: 5.794.3; p<0.001) were associated with PA isolation. No relationship was seen between bronchiectasis in HRCT and antibiotic use in the previous 3 months. Conclusions. PA in sputum at hospital admission is more frequent in patients with poorer scoring on the BODE index, previous admissions, oral corticosteroids and prior isolation of PA.