Impact of Pseudomonas aeruginosa on exacerbation and death in patients with chronic obstructive pulmonary disease

Background: The impact of P. aeruginosa on long-term prognosis in COPD remains unknown. Objective: To determine whether P. aeruginosa is associated with increased risk of exacerbation or death in patients with COPD. Methods: Observational cohort study on 22.053 COPD outpatients (Fig.1). Time-dependent Cox proportional hazard regression model was used to estimate a) hospitalisation for exacerbation or all-cause mortality and b) all-cause mortality after 2 years. Results:P. aeruginosa was found in 4.1% of the patients. Hospital admissions (80% and 48%,p Conclusions:P. aeruginosa is associated with substantially worsened long-term prognosis in COPD. A randomized controlled trial is needed to conclude whether targeted antibiotic interventions can improve the prognosis in this highly vulnerable group of patients.