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Pseudomonas aeruginosa in adults with chronic obstructive pulmonary disease

Murphy, Timothy Fa,b

Current Opinion in Pulmonary Medicine: March 2009 - Volume 15 - Issue 2 - p 138–142
doi: 10.1097/MCP.0b013e328321861a
Obstructive, occupational and environmental diseases: Edited by Basil Varkey
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Purpose of review Pseudomonas aeruginosa is isolated in sputum cultures from adults with chronic obstructive pulmonary disease (COPD) but the significance of the organism in this clinical setting is not well known. The purpose of this review is to critically review the literature in an effort to understand the role of P. aeruginosa in the course and pathogenesis of COPD.

Recent findings When examined longitudinally, two distinct patterns of carriage of P. aeruginosa are observed in adults with COPD: short-term colonization followed by clearance and long-term persistence. Acquisition of P. aeruginosa is associated with the occurrence of an exacerbation, indicating that the organism causes exacerbations. Exacerbations caused by P. aeruginosa are more likely to be seen in patients with more advanced COPD, those who have received recent antibiotic therapy and those who require mechanical ventilation for an exacerbation. A subset of adults with COPD becomes chronically colonized with P. aeruginosa, but whether such patients benefit from antimicrobial therapy is not yet known.

Summary P. aeruginosa has several different manifestations in the setting of COPD. The organism is a colonizer that is cleared quickly, causes acute exacerbations and also may cause chronic infection in a subset of adults with COPD.

aDivision of Infectious Disease, Department of Medicine and Department of Microbiology, University at Buffalo, State University of New York, USA

bVeterans Affairs Western New York Healthcare System, Buffalo, New York, USA

Correspondence to Timothy F. Murphy, MD, Veterans Affairs Western New York Healthcare System, Medical Research 151, 3495 Bailey Avenue, Buffalo, NY 14215, USA Tel: +1 716 862 7874; fax: +1 716 862 6526; e-mail: murphyt@buffalo.edu

© 2009 Lippincott Williams & Wilkins, Inc.