https://doi.org/10.4081/monaldi.2023.2718

Non-cystic fibrosis bronchiectasis: a retrospective review of clinical, radiological, microbiological and lung function profile at a tertiary care center of low-middle income country

Early Access
Submitted: July 18, 2023
Accepted: August 28, 2023
Published: September 12, 2023
Bronchiectasis, non-cystic fibrosis, etiology, infectious diseases, clinical findings
Abstract Views: 939
PDF_early view: 503
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Authors

Shayan Shahid
https://orcid.org/0000-0002-5676-5462
Section of Pulmonary and Critical Care Medicine, Department of Medicine, Aga Khan University, Karachi, Pakistan.
Ali bin Abdul Jabbar
https://orcid.org/0000-0001-5145-8626
Medical College, Aga Khan University, Karachi, Pakistan.
Abdullah Wagley
https://orcid.org/0000-0003-4587-9971
Medical College, Aga Khan University, Karachi, Pakistan.
Muhammad Daniyal Musharraf
Medical College, Aga Khan University, Karachi, Pakistan.
Haris Zahid
https://orcid.org/0000-0003-1312-3301
Medical College, Aga Khan University, Karachi, Pakistan.
Syed Muhammad Zubair
https://orcid.org/0000-0002-5917-246X
Section of Pulmonary and Critical Care Medicine, Department of Medicine, Aga Khan University, Karachi, Pakistan.
Muhammad Irfan
muhammad.irfan@aku.edu
https://orcid.org/0000-0002-5796-2548
Section of Pulmonary and Critical Care Medicine, Department of Medicine, Aga Khan University, Karachi, Pakistan.

Non-cystic fibrosis (non-CF) bronchiectasis has emerged as a significant respiratory disease in developing countries. Given the variation in causes and clinical characteristics across different regions, it is necessary to conduct studies in regions with limited data such as low-middle income countries (LMIC). The aim of the study was to investigate the underlying causes, clinical presentation, etiology, lung function and imaging in patients with bronchiectasis who sought treatment at a tertiary care hospital in a LMIC. We conducted retrospective observational study at the Aga Khan University, Pakistan. Adult patients diagnosed with non-CF bronchiectasis on high-resolution computed tomography scan between 2000 and 2020 were included. We evaluated the etiology, clinical characteristics, microbiology, radiology and spirometric pattern of these patients. A total of 340 patients were included with 56.5% being female and 44.7% aged over 60 years. Among them, 157 (46.2%) had experienced symptoms for 1-5 years. The most common spirometric pattern observed was obstructive impairment (58.1%). Previous tuberculosis (TB) (52.94%) was the most common etiology followed by allergic bronchopulmonary aspergillosis (7.64%). Bilateral lung involvement on HRCT scan was found in 63.2% of patients. Pseudomonas aeruginosa was the most frequently identified organism (38.75%) among 240 patients with available specimens. Patients with P. aeruginosa infections had a significantly higher number of exacerbations (p=0.016). There was a significant difference (p<0.001) in P. aeruginosa growth among different etiologies. In conclusion, post-TB bronchiectasis was the most common cause of non-CF bronchiectasis in our study population. P. aeruginosa was the predominant organism, and 63.2% of the patients exhibited bilateral lung involvement. Since P. aeruginosa growth and extensive lung involvement have been associated with poor prognosis and increased mortality risk, we recommend close follow ups of these patients to improve quality of life and survival in developing countries like Pakistan.

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Ethics Approval

Given the retrospective chart reviews and lack of direct involvement of patients or other human participants, a waiver of ethics approval and informed consent was obtained from the Ethics Review Committee of the Aga Khan University

How to Cite

Shahid, Shayan, Ali bin Abdul Jabbar, Abdullah Wagley, Muhammad Daniyal Musharraf, Haris Zahid, Syed Muhammad Zubair, and Muhammad Irfan. 2023. “Non-Cystic Fibrosis Bronchiectasis: A Retrospective Review of Clinical, Radiological, Microbiological and Lung Function Profile at a Tertiary Care Center of Low-Middle Income Country”. Monaldi Archives for Chest Disease, September. https://doi.org/10.4081/monaldi.2023.2718.
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