Skip to main content
NCBI home page
Thorax logoLink to Thorax
. 1997 Mar;52(3):260–264. doi: 10.1136/thx.52.3.260

Effects of airway infection by Pseudomonas aeruginosa: a computed tomographic study

K A Miszkiel, A U Wells, M B Rubens, P J Cole, D M Hansell
PMCID: PMC1758513  PMID: 9093343

Abstract

BACKGROUND: Pseudomonas aeruginosa commonly infects the airways of patients with bronchiectasis. A study was undertaken to examine the relationship between infection of the airways with this pathogen, the morphological pattern of bronchiectasis on thin section computed tomographic (CT) scanning, symptom duration, smoking habits of the patients, and the presence of airflow obstruction. METHODS: Thin section CT scans of 22 adult patients with bronchiectasis and concurrent sputum infected by P aeruginosa (Pa +ve) and those of 45 randomly selected patients not infected by P aeruginosa (Pa -ve) were analysed independently by two thoracic radiologists. Patients with cystic fibrosis were excluded. Each scan was scored at a lobar level for extent of bronchiectasis, severity of bronchial wall thickening and dilatation, predominant pattern of bronchiectasis, presence of mucus plugging, and degree of decreased attenuation of the lung parenchyma. RESULTS: The Pa +ve group had more extensive bronchiectasis and a greater degree of bronchial wall thickening and dilatation on the CT scan than the Pa -ve group; more extensive decreased attenuation was seen in the Pa +ve group. These findings were robust on multivariate analysis; decreased attenuation was also independently related to the duration of sputum production. CONCLUSION: Patients with bronchiectasis infected by P aeruginosa have more extensive and severe bronchiectasis on thin section CT scanning than those without P aeruginosa infection. The bronchi and small airways are both involved, reflecting the end result of complex interactions between host airways and the numerous virulence factors produced by P aeruginosa. 




Full Text

The Full Text of this article is available as a PDF (158.4 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Amitani R., Wilson R., Rutman A., Read R., Ward C., Burnett D., Stockley R. A., Cole P. J. Effects of human neutrophil elastase and Pseudomonas aeruginosa proteinases on human respiratory epithelium. Am J Respir Cell Mol Biol. 1991 Jan;4(1):26–32. doi: 10.1165/ajrcmb/4.1.26. [DOI] [PubMed] [Google Scholar]
  2. Brennan P., Silman A. Statistical methods for assessing observer variability in clinical measures. BMJ. 1992 Jun 6;304(6840):1491–1494. doi: 10.1136/bmj.304.6840.1491. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Grenier P., Cordeau M. P., Beigelman C. High-resolution computed tomography of the airways. J Thorac Imaging. 1993 Summer;8(3):213–229. doi: 10.1097/00005382-199322000-00006. [DOI] [PubMed] [Google Scholar]
  4. Hansell D. M., Wells A. U., Rubens M. B., Cole P. J. Bronchiectasis: functional significance of areas of decreased attenuation at expiratory CT. Radiology. 1994 Nov;193(2):369–374. doi: 10.1148/radiology.193.2.7972745. [DOI] [PubMed] [Google Scholar]
  5. Lapa e Silva J. R., Guerreiro D., Noble B., Poulter L. W., Cole P. J. Immunopathology of experimental bronchiectasis. Am J Respir Cell Mol Biol. 1989 Oct;1(4):297–304. doi: 10.1165/ajrcmb/1.4.297. [DOI] [PubMed] [Google Scholar]
  6. Munro N. C., Barker A., Rutman A., Taylor G., Watson D., McDonald-Gibson W. J., Towart R., Taylor W. A., Wilson R., Cole P. J. Effect of pyocyanin and 1-hydroxyphenazine on in vivo tracheal mucus velocity. J Appl Physiol (1985) 1989 Jul;67(1):316–323. doi: 10.1152/jappl.1989.67.1.316. [DOI] [PubMed] [Google Scholar]
  7. Müller N. L., Miller R. R. Diseases of the bronchioles: CT and histopathologic findings. Radiology. 1995 Jul;196(1):3–12. doi: 10.1148/radiology.196.1.7784583. [DOI] [PubMed] [Google Scholar]
  8. Nagaki M., Shimura S., Tanno Y., Ishibashi T., Sasaki H., Takishima T. Role of chronic Pseudomonas aeruginosa infection in the development of bronchiectasis. Chest. 1992 Nov;102(5):1464–1469. doi: 10.1378/chest.102.5.1464. [DOI] [PubMed] [Google Scholar]
  9. Naidich D. P., McCauley D. I., Khouri N. F., Stitik F. P., Siegelman S. S. Computed tomography of bronchiectasis. J Comput Assist Tomogr. 1982 Jun;6(3):437–444. doi: 10.1097/00004728-198206000-00001. [DOI] [PubMed] [Google Scholar]
  10. Pitt T. L. Biology of Pseudomonas aeruginosa in relation to pulmonary infection in cystic fibrosis. J R Soc Med. 1986;79 (Suppl 12):13–18. [PMC free article] [PubMed] [Google Scholar]
  11. REID L. McA. Reduction in bronchial subdivision in bronchiectasis. Thorax. 1950 Sep;5(3):233–247. doi: 10.1136/thx.5.3.233. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Rayner C. F., Tillotson G., Cole P. J., Wilson R. Efficacy and safety of long-term ciprofloxacin in the management of severe bronchiectasis. J Antimicrob Chemother. 1994 Jul;34(1):149–156. doi: 10.1093/jac/34.1.149. [DOI] [PubMed] [Google Scholar]
  13. Read R. C., Roberts P., Munro N., Rutman A., Hastie A., Shryock T., Hall R., McDonald-Gibson W., Lund V., Taylor G. Effect of Pseudomonas aeruginosa rhamnolipids on mucociliary transport and ciliary beating. J Appl Physiol (1985) 1992 Jun;72(6):2271–2277. doi: 10.1152/jappl.1992.72.6.2271. [DOI] [PubMed] [Google Scholar]
  14. Regelmann W. E., Elliott G. R., Warwick W. J., Clawson C. C. Reduction of sputum Pseudomonas aeruginosa density by antibiotics improves lung function in cystic fibrosis more than do bronchodilators and chest physiotherapy alone. Am Rev Respir Dis. 1990 Apr;141(4 Pt 1):914–921. doi: 10.1164/ajrccm/141.4_Pt_1.914. [DOI] [PubMed] [Google Scholar]
  15. Reiff D. B., Wells A. U., Carr D. H., Cole P. J., Hansell D. M. CT findings in bronchiectasis: limited value in distinguishing between idiopathic and specific types. AJR Am J Roentgenol. 1995 Aug;165(2):261–267. doi: 10.2214/ajr.165.2.7618537. [DOI] [PubMed] [Google Scholar]
  16. Reynolds H. Y., Di Sant'Agnese P. A., Zierdt C. H. Mucoid Pseudomonas aeruginosa. A sign of cystic fibrosis in young adults with chronic pulmonary disease? JAMA. 1976 Nov 8;236(19):2190–2192. doi: 10.1001/jama.236.19.2190. [DOI] [PubMed] [Google Scholar]
  17. Rivera M., Nicotra M. B. Pseudomonas aeruginosa mucoid strain. Its significance in adult chest diseases. Am Rev Respir Dis. 1982 Nov;126(5):833–836. doi: 10.1164/arrd.1982.126.5.833. [DOI] [PubMed] [Google Scholar]
  18. Somerville M., Richardson P. S., Rutman A., Wilson R., Cole P. J. Stimulation of secretion into human and feline airways by Pseudomonas aeruginosa proteases. J Appl Physiol (1985) 1991 May;70(5):2259–2267. doi: 10.1152/jappl.1991.70.5.2259. [DOI] [PubMed] [Google Scholar]
  19. Stockley R. A., Hill S. L., Morrison H. M., Starkie C. M. Elastolytic activity of sputum and its relation to purulence and to lung function in patients with bronchiectasis. Thorax. 1984 Jun;39(6):408–413. doi: 10.1136/thx.39.6.408. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Tsang K. W., Rutman A., Tanaka E., Lund V., Dewar A., Cole P. J., Wilson R. Interaction of Pseudomonas aeruginosa with human respiratory mucosa in vitro. Eur Respir J. 1994 Oct;7(10):1746–1753. doi: 10.1183/09031936.94.07101746. [DOI] [PubMed] [Google Scholar]
  21. Valerius N. H., Koch C., Høiby N. Prevention of chronic Pseudomonas aeruginosa colonisation in cystic fibrosis by early treatment. Lancet. 1991 Sep 21;338(8769):725–726. doi: 10.1016/0140-6736(91)91446-2. [DOI] [PubMed] [Google Scholar]
  22. Wilson R., Pitt T., Taylor G., Watson D., MacDermot J., Sykes D., Roberts D., Cole P. Pyocyanin and 1-hydroxyphenazine produced by Pseudomonas aeruginosa inhibit the beating of human respiratory cilia in vitro. J Clin Invest. 1987 Jan;79(1):221–229. doi: 10.1172/JCI112787. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Young K., Aspestrand F., Kolbenstvedt A. High resolution CT and bronchography in the assessment of bronchiectasis. Acta Radiol. 1991 Nov;32(6):439–441. [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES