Risk factors for mortality in patients with Pseudomonas aeruginosa pneumonia: Clinical impact of mucA gene mutation

In Young Jung, Su Jin Jeong, Kang Mu Lee, Jin Young Ahn, Nam Su Ku, Sang Hoon Han, Jun Yong Choi, Dongeun Yong, Sang Sun Yoon, Young Goo Song, Seok Hoon Jeong, June Myung Kim, Kyungwon Lee

Research output: Contribution to journalArticle

Abstract

Objectives: Pseudomonas aeruginosa frequently colonizes the lungs of chronic obstructive pulmonary disease (COPD) patients. Mucoid conversion is a hallmark of chronic P. aeruginosa infection, which is mediated by mucA gene mutations. The aim of this study is to identify predictive factors for mortality and the influence of mucA gene mutation in COPD patients with P. aeruginosa pneumonia. Methods: This study assessed 75 COPD patients with P. aeruginosa pneumonia at two university hospitals. The clinical and laboratory data were collected, and the P. aeruginosa isolates analyzed for the presence of mucA gene mutations. Results: MucA gene mutation of P. aeruginosa was an independent predictor of mortality (odds ratio [OR] 10.43, 95% confidence interval [CI]: 1.53–70.90, p = 0.017). In addition, the APACHE II score and C-reactive protein/Albumin (CA) ratio were independent predictive factors for mortality (OR 1.25, 95% CI: 1.07–1.46, p = 0.004; and OR 1.06, 95% CI: 1.02–1.10, p = 0.003, respectively). The optimal cutoff value of CA ratio for the greatest sensitivity and specificity was calculated as 31.27 (sensitivity, 85.7%; specificity, 80.3%). Conclusions: CA ratio and mucA gene mutation of P. aeruginosa could be used as predictors to identify poor prognosis in COPD patients with P. aeruginosa pneumonia.

Original languageEnglish
Pages (from-to)27-31
Number of pages5
JournalRespiratory Medicine
Volume140
DOIs
Publication statusPublished - 2018 Jul

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Pseudomonas aeruginosa
Pneumonia
Mutation
Mortality
Chronic Obstructive Pulmonary Disease
Genes
C-Reactive Protein
Albumins
Odds Ratio
Confidence Intervals
Pseudomonas Infections
APACHE
Sensitivity and Specificity
Lung

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine

Cite this

Jung, In Young ; Jeong, Su Jin ; Lee, Kang Mu ; Ahn, Jin Young ; Ku, Nam Su ; Han, Sang Hoon ; Choi, Jun Yong ; Yong, Dongeun ; Yoon, Sang Sun ; Song, Young Goo ; Jeong, Seok Hoon ; Kim, June Myung ; Lee, Kyungwon. / Risk factors for mortality in patients with Pseudomonas aeruginosa pneumonia : Clinical impact of mucA gene mutation. In: Respiratory Medicine. 2018 ; Vol. 140. pp. 27-31.
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abstract = "Objectives: Pseudomonas aeruginosa frequently colonizes the lungs of chronic obstructive pulmonary disease (COPD) patients. Mucoid conversion is a hallmark of chronic P. aeruginosa infection, which is mediated by mucA gene mutations. The aim of this study is to identify predictive factors for mortality and the influence of mucA gene mutation in COPD patients with P. aeruginosa pneumonia. Methods: This study assessed 75 COPD patients with P. aeruginosa pneumonia at two university hospitals. The clinical and laboratory data were collected, and the P. aeruginosa isolates analyzed for the presence of mucA gene mutations. Results: MucA gene mutation of P. aeruginosa was an independent predictor of mortality (odds ratio [OR] 10.43, 95{\%} confidence interval [CI]: 1.53–70.90, p = 0.017). In addition, the APACHE II score and C-reactive protein/Albumin (CA) ratio were independent predictive factors for mortality (OR 1.25, 95{\%} CI: 1.07–1.46, p = 0.004; and OR 1.06, 95{\%} CI: 1.02–1.10, p = 0.003, respectively). The optimal cutoff value of CA ratio for the greatest sensitivity and specificity was calculated as 31.27 (sensitivity, 85.7{\%}; specificity, 80.3{\%}). Conclusions: CA ratio and mucA gene mutation of P. aeruginosa could be used as predictors to identify poor prognosis in COPD patients with P. aeruginosa pneumonia.",
author = "Jung, {In Young} and Jeong, {Su Jin} and Lee, {Kang Mu} and Ahn, {Jin Young} and Ku, {Nam Su} and Han, {Sang Hoon} and Choi, {Jun Yong} and Dongeun Yong and Yoon, {Sang Sun} and Song, {Young Goo} and Jeong, {Seok Hoon} and Kim, {June Myung} and Kyungwon Lee",
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Risk factors for mortality in patients with Pseudomonas aeruginosa pneumonia : Clinical impact of mucA gene mutation. / Jung, In Young; Jeong, Su Jin; Lee, Kang Mu; Ahn, Jin Young; Ku, Nam Su; Han, Sang Hoon; Choi, Jun Yong; Yong, Dongeun; Yoon, Sang Sun; Song, Young Goo; Jeong, Seok Hoon; Kim, June Myung; Lee, Kyungwon.

In: Respiratory Medicine, Vol. 140, 07.2018, p. 27-31.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Risk factors for mortality in patients with Pseudomonas aeruginosa pneumonia

T2 - Clinical impact of mucA gene mutation

AU - Jung, In Young

AU - Jeong, Su Jin

AU - Lee, Kang Mu

AU - Ahn, Jin Young

AU - Ku, Nam Su

AU - Han, Sang Hoon

AU - Choi, Jun Yong

AU - Yong, Dongeun

AU - Yoon, Sang Sun

AU - Song, Young Goo

AU - Jeong, Seok Hoon

AU - Kim, June Myung

AU - Lee, Kyungwon

PY - 2018/7

Y1 - 2018/7

N2 - Objectives: Pseudomonas aeruginosa frequently colonizes the lungs of chronic obstructive pulmonary disease (COPD) patients. Mucoid conversion is a hallmark of chronic P. aeruginosa infection, which is mediated by mucA gene mutations. The aim of this study is to identify predictive factors for mortality and the influence of mucA gene mutation in COPD patients with P. aeruginosa pneumonia. Methods: This study assessed 75 COPD patients with P. aeruginosa pneumonia at two university hospitals. The clinical and laboratory data were collected, and the P. aeruginosa isolates analyzed for the presence of mucA gene mutations. Results: MucA gene mutation of P. aeruginosa was an independent predictor of mortality (odds ratio [OR] 10.43, 95% confidence interval [CI]: 1.53–70.90, p = 0.017). In addition, the APACHE II score and C-reactive protein/Albumin (CA) ratio were independent predictive factors for mortality (OR 1.25, 95% CI: 1.07–1.46, p = 0.004; and OR 1.06, 95% CI: 1.02–1.10, p = 0.003, respectively). The optimal cutoff value of CA ratio for the greatest sensitivity and specificity was calculated as 31.27 (sensitivity, 85.7%; specificity, 80.3%). Conclusions: CA ratio and mucA gene mutation of P. aeruginosa could be used as predictors to identify poor prognosis in COPD patients with P. aeruginosa pneumonia.

AB - Objectives: Pseudomonas aeruginosa frequently colonizes the lungs of chronic obstructive pulmonary disease (COPD) patients. Mucoid conversion is a hallmark of chronic P. aeruginosa infection, which is mediated by mucA gene mutations. The aim of this study is to identify predictive factors for mortality and the influence of mucA gene mutation in COPD patients with P. aeruginosa pneumonia. Methods: This study assessed 75 COPD patients with P. aeruginosa pneumonia at two university hospitals. The clinical and laboratory data were collected, and the P. aeruginosa isolates analyzed for the presence of mucA gene mutations. Results: MucA gene mutation of P. aeruginosa was an independent predictor of mortality (odds ratio [OR] 10.43, 95% confidence interval [CI]: 1.53–70.90, p = 0.017). In addition, the APACHE II score and C-reactive protein/Albumin (CA) ratio were independent predictive factors for mortality (OR 1.25, 95% CI: 1.07–1.46, p = 0.004; and OR 1.06, 95% CI: 1.02–1.10, p = 0.003, respectively). The optimal cutoff value of CA ratio for the greatest sensitivity and specificity was calculated as 31.27 (sensitivity, 85.7%; specificity, 80.3%). Conclusions: CA ratio and mucA gene mutation of P. aeruginosa could be used as predictors to identify poor prognosis in COPD patients with P. aeruginosa pneumonia.

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