Acute exacerbation of bronchiectasis – Experience of a Tunisian pulmonology department

<b>Background:</b> Patients with bronchiectasis (BC) are prone to recurrent acute exacerbations (AE), which are associated with significant morbi-mortality. We aimed to determine the clinical and biological features of AE in patients (pts) with post-tuberculosis BC compared to other etiologies of BC. <b>Methods:</b> Retrospective study of pts admitted to with AE of BC. Two groups compared: G1 (40 pts with post-tuberculosis BC) vs G0 (62 pts with other etiologies of BC). <b>Results:</b> One hundred and two men were included; with a mean age of 64 years. BC were idiopathic in 28% of pts. Thirty percent of pts had respiratory comorbidities. Use of inhaled corticosteroids was noted in 2% of pts in G1 vs 46% in G0 (p=0.04). Long term non invasive ventilation and long-term oxygen therapy were found respectively in [G1&nbsp;:4% vs G0&nbsp;:18%&nbsp;; p=0.02] and [G1&nbsp;:11% vs G0&nbsp;:28%&nbsp;; p=NS]. There were 142 AE requiring admission; one-third of pts had 2 or more per year. G1 pts had a mean annual number of admissions higher than those in G0 (2 vs 1, p=0.03). Forty-five percent of G1 pts were admitted in acute respiratory failure vs 30% for G0&nbsp;(p=0.04). Bronchial infection was found in 70% of pts. The bacteriological diagnosis was obtained in 80% of cases. Most common pathogens were: Pseudomonas Aeruginosa (PA) [G1&nbsp;:21% vs G0&nbsp;:13%; p=0.02]; Haemophilus influenzae (HI) [G1: 18% vs G0: 16%; p=NS]&nbsp;and Klebsiella pneumoniae (KP) [G1&nbsp;:18% vs G0&nbsp;:7%; p=0,04]. All pts received antibiotic therapy with a mean duration of 12 days. Transfer to medical intensive care unit was needed in 11% of pts in G1 vs 7.5% in G0; p=0,04. <b>Conclusion:</b> AE in post-tuberculosis BC were more frequent and more severe. PA, HI, and KP were the most common pathogenes