Prevalence of relevant multi-drug resistant (MDR) pathogens in a bronchiectasis (BE) cohort

<b>Background:</b> 60% of BE patients suffer bronchial infection, leading to frequent antibiotics and high risk of MDR. <b>Aim:</b> to describe the prevalence of MDR S. aureus (SA) and P. aeruginosa (PA) in a cohort of BE patients from Barcelona (Spain). <b>Methods:</b> Inclusion criteria: age ≥18y, documented BE, at least 1 sputum culture along 2018. According to EUCAST (PMID: 21793988) isolates were classified as susceptible (S) or MDR (R≥3 antibiotic categories). <b>Results:</b> 198 patients were included; 71 had ≥1 positive sputum culture. 53 (26.8%) and 23 (11.6%) had ≥1 PA or SA isolate respectively (Fig1). 11/53 patients carried MDR PA (20.8%) and 10/11 had MDR PA in previous years). The least active drugs against MDR PA were Piperacillin-Tazobactam and 3rd/4th gen. cephalosporins (91.7% R each), ciprofloxacin (75%R), and aminoglycosides (50%R). Colistin was the most active against PA (94.8%S). Only 6 patients (20%) carried Oxacilin R SA. Factors associated with MDR PA were ≥2 exacerbations in the previous year (OR=8.5;95%CI:1.9-38.4; p=0.005) and increased severity scores (E-FACED 6-9, OR=7.5; 95%IC=1.1–52.4; p=0.041). Chronic inhaled antibiotics showed a trend to association with MDR PA (OR=2,6; 95%IC:0.65-10.2;p=0.178). Non significant trends were observed for MDR SA. <b>Conclusions:</b> MDR infections are prevalent and associated with frequent use of antibiotics and disease severity. Strategies to reduce the risk of MDR in BE are needed.