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Background <p>Bronchiectasis is a chronic respiratory disease characterized by recurrent exacerbations and persistent inflammation, often associated with bacterial pathogens such as <i>Haemophilus influenzae</i> and <i>Pseudomonas aeruginosa</i>. Phenotypic adaptations (e.g., antimicrobial resistance) complicate treatment and worsen a patient’s quality of life.</p> Methods <p>Between 2019 and 2020, we isolated 52 <i>H. influenzae</i> and 48 <i>P. aeruginosa</i> strains from 62 non-CF bronchiectasis patients across three scheduled visits and during exacerbation episodes. Antimicrobial susceptibility (assessed by microdilution) and phenotyping assays (motility and hypermutability) were performed. Whole genome sequencing was applied for analyses of resistance determinants, virulence factors, and genetic diversity.</p> Results <p>Of the 62 patients, 31 were colonized by <i>H. influenzae</i>, 28 by <i>P. aeruginosa</i>, and 3 were co-colonized. Severe disease was predominantly linked to <i>P. aeruginosa</i> (70.6%), while exacerbations were more common with <i>H. influenzae</i> (81.8%). Multilocus sequence typing (MLST) revealed high genetic diversity, with ST1025 and ST253 most common in <i>H. influenzae</i> and <i>P. aeruginosa</i>, respectively. Antimicrobial resistance was low, but <i>H. influenzae</i> showed the highest resistance to cotrimoxazole (40.4%), while <i>P. aeruginosa</i> showed high resistance to aminoglycosides (27.1%) and fluoroquinolones (25%). Virulence profiling of <i>P. aeruginosa</i> identified 22.9% of strains as hypermutable, 27.1% as mucoid, 31.3% harboring the <i>exoU</i> gene, and 41.7% with impaired twitching motility. Persistent colonization occurred in 16 patients (25.8%), with antimicrobial resistance emerging following previous antimicrobial treatment in one case.</p> Conclusions <p>In this cohort, <i>H. influenzae</i> and <i>P. aeruginosa</i> showed similar prevalence, high genetic diversity, and rare co-colonization. <i>P. aeruginosa</i> was associated with more severe disease, higher antimicrobial resistance, and hypermutability, whereas <i>H. influenzae</i> was associated with acute exacerbations.</p>

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Epidemiological insights into Haemophilus influenzae and Pseudomonas aeruginosa persistent colonization in non-cystic fibrosis bronchiectasis patients: a longitudinal and multicenter study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月16日

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  • Irene Cadenas-Jiménez,
  • Paula Camps-Massa,
  • Filipe Gonçalves-Carvalho,
  • Yasmina Benaali-Bakkar,
  • Sara Quero,
  • Laura Rodríguez,
  • Adrián Antuori,
  • Lucía Saiz-Escobedo,
  • Sara Calvo-Silveria,
  • Antonio Oliver,
  • M Angeles Dominguez,
  • Fe Tubau,
  • Aida González-Díaz,
  • Carmen Ardanuy,
  • Salud Santos,
  • Alicia Marin,
  • Elisenda Arque,
  • Laura Millares,
  • Marina Simon,
  • Ignasi Garcia-Olivé,
  • Cristina Prat-Aymerich,
  • Alicia Lacoma,
  • Esther Barreiro,
  • Annie Navarro,
  • Virginia Plasencia,
  • Eva Cuchí,
  • Javier Pomares,
  • Concepción Montón,
  • Antonio Casabella,
  • Montserrat Vendrell,
  • Gerard Muñoz,
  • Eva Polverino,
  • Antonia Llunell,
  • Guillermo Suárez-Cuartin,
  • Carmen Calero,
  • Sara Martí

摘要

Background

Bronchiectasis is a chronic respiratory disease characterized by recurrent exacerbations and persistent inflammation, often associated with bacterial pathogens such as Haemophilus influenzae and Pseudomonas aeruginosa. Phenotypic adaptations (e.g., antimicrobial resistance) complicate treatment and worsen a patient’s quality of life.

Methods

Between 2019 and 2020, we isolated 52 H. influenzae and 48 P. aeruginosa strains from 62 non-CF bronchiectasis patients across three scheduled visits and during exacerbation episodes. Antimicrobial susceptibility (assessed by microdilution) and phenotyping assays (motility and hypermutability) were performed. Whole genome sequencing was applied for analyses of resistance determinants, virulence factors, and genetic diversity.

Results

Of the 62 patients, 31 were colonized by H. influenzae, 28 by P. aeruginosa, and 3 were co-colonized. Severe disease was predominantly linked to P. aeruginosa (70.6%), while exacerbations were more common with H. influenzae (81.8%). Multilocus sequence typing (MLST) revealed high genetic diversity, with ST1025 and ST253 most common in H. influenzae and P. aeruginosa, respectively. Antimicrobial resistance was low, but H. influenzae showed the highest resistance to cotrimoxazole (40.4%), while P. aeruginosa showed high resistance to aminoglycosides (27.1%) and fluoroquinolones (25%). Virulence profiling of P. aeruginosa identified 22.9% of strains as hypermutable, 27.1% as mucoid, 31.3% harboring the exoU gene, and 41.7% with impaired twitching motility. Persistent colonization occurred in 16 patients (25.8%), with antimicrobial resistance emerging following previous antimicrobial treatment in one case.

Conclusions

In this cohort, H. influenzae and P. aeruginosa showed similar prevalence, high genetic diversity, and rare co-colonization. P. aeruginosa was associated with more severe disease, higher antimicrobial resistance, and hypermutability, whereas H. influenzae was associated with acute exacerbations.