Microbiology and Treatment Outcome of Acute Exacerbation of Bronchiectasis in Hong Kong

Microbiology and Treatment Outcome of Acute Exacerbation of Bronchiectasis in Hong Kong: a Prospective Study

Bronchiectasis is a common disease worldwide with a high burden on healthcare resources. In Hong Kong (HK), local microbiological and clinical data regarding acute exacerbation of bronchiectasis (AEB) is lacking, in particular the frequency of pseudomonas aeruginosa (PA) in AEB is yet to be elucidated. A better understanding of the microbiology of AEB will provide evidence for judicious use of appropriate antibiotics in patients hospitalized for AEB to facilitate treatment and discharge.

This study aims to

1. elucidate the microbiology of AEB using both traditional culture and newer molecular multiplex methods,
2. identify factors associated with PA infection, and
3. describe the management and treatment outcome of AEB in HK

Study Overview

• Status: Recruiting
• Conditions: Bronchiectasis

Detailed Description

Bronchiectasis is a common disease worldwide with a high burden on healthcare resources. In Hong Kong (HK), bronchiectasis ranked 5th highest as a cause of respiratory mortality, was the 6th highest reason for respiratory inpatient bed-days and was the 7th highest cause of respiratory hospitalization in Hong Kong in 2005.

Local microbiological and clinical data regarding acute exacerbation of bronchiectasis (AEB) is lacking, in particular the frequency of pseudomonas aeruginosa (PA) in AEB is yet to be elucidated. Traditional respiratory specimen takes time and lack sensitivity, a newer multiplex molecular method may be beneficial in improving sensitivity and reducing turnover time to detect pathogens involved in AEB. A better understanding of the microbiology of AEB will provide evidence for judicious use of appropriate antibiotics in patients hospitalized for AEB to facilitate treatment and discharge.

This study aims to

1. elucidate the microbiology of AEB using both traditional culture and newer molecular multiplex methods,
2. identify factors associated with PA infection, and
3. describe the management and treatment outcome of AEB in HK

• Study Type: Observational
• Enrollment (Estimated): 200

Contacts and Locations

• Study Contact: Name: Charles Wong; Phone Number: 25956111; Email: wc679@ha.org.hk

Study Locations

• Hong Kong
  • Other
    • Hong Kong, Other, Hong Kong
      • Recruiting
      • Charles Wong
      • Contact: Charles Wong; Phone Number: 25956111; Email: wc679@ha.org.hk

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

This is a prospective observational study of patients who are admitted to the participating hospital with acute exacerbations of bronchiectasis.

Description

Inclusion Criteria

1. Patients admitted to participating hospital with a clinical diagnosis of acute exacerbation of bronchiectasis (AEB), defined as a change in bronchiectasis treatment associated with deterioration in three or more of the following key symptoms for at least 48 hours: cough; sputum volume and/or consistency; sputum purulence; breathlessness and/or exercise tolerance; fatigue and/or malaise; or haemoptysis.
2. Patients with an established diagnosis of bronchiectasis, defined as the presence of cough, shortness of breath, chronic sputum production, recurrent respiratory infection, or a combination thereof with CT thorax scan confirmation of the presence of bronchiectasis indicated by a bronchoarterial ratio of > 1, lack of tapering, airway visibility within 1 cm of the pleural surface, or a combination thereof.

Exclusion criteria

1. Patients unable to provide informed consent
2. Age < 18 years
3. Pregnancy
4. Bronchiectasis due to known cystic fibrosis
5. Bronchiectasis is not the main or co-dominant respiratory disease
6. Traction bronchiectasis due to interstitial lung disease
7. Prior lung transplantation for bronchiectasis

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Microbiology	Frequency of pseudomonas aeruginosa (PA) and non-PA infection	1 month
Risk factors for PA infection	Risk factors for PA infection	1 month

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Antibiotics use	Length of antibiotics use (days)	1 month
Length of stay	Length of hospital stay for AEB (days)	1 month
Recurrent exacerbation	Frequency of recurrent exacerbation	12 months
Mortality	Rate of all-cause mortality in 1 year	12 months

Collaborators and Investigators

• Sponsor: Pamela Youde Nethersole Eastern Hospital
• Investigators: Principal Investigator: Charles Wong, Pamela Youde Nethersole Eastern Hospital

Study record dates

Study Major Dates

• Study Start (Actual): December 2, 2021
• Primary Completion (Estimated): February 28, 2025
• Study Completion (Estimated): December 1, 2025

Study Registration Dates

• First Submitted: October 8, 2021
• First Submitted That Met QC Criteria: October 27, 2021
• First Posted (Actual): November 8, 2021

Study Record Updates

• Last Update Posted (Actual): April 3, 2024
• Last Update Submitted That Met QC Criteria: April 2, 2024
• Last Verified: April 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Respiratory Tract Diseases; Bronchial Diseases; Bronchiectasis
• Other Study ID Numbers: Pro_AEB_2021

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No