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Transmission of bacteria in bronchiectasis and chronic obstructive pulmonary disease: Low burden of cough aerosols
Author(s) -
Stockwell Rebecca E.,
Chin Melanie,
Johnson Graham R.,
Wood Michelle E.,
Sherrard Laura J.,
Ballard Emma,
O'Rourke Peter,
Ramsay Kay A.,
Kidd Timothy J.,
Jabbour Nassib,
Thomson Rachel M.,
Knibbs Luke D.,
Morawska Lidia,
Bell Scott C.
Publication year - 2019
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/resp.13544
Subject(s) - bronchiectasis , pseudomonas aeruginosa , medicine , sputum , cystic fibrosis , copd , aerosol , genotyping , airborne transmission , respiratory disease , sputum culture , microbiology and biotechnology , lung , immunology , disease , bacteria , genotype , pathology , biology , tuberculosis , covid-19 , physics , meteorology , infectious disease (medical specialty) , genetics , biochemistry , gene
Background and objective Aerosol transmission of Pseudomonas aeruginosa has been suggested as a possible mode of respiratory infection spread in patients with cystic fibrosis (CF); however, whether this occurs in other suppurative lung diseases is unknown. Therefore, we aimed to determine if (i) patients with bronchiectasis (unrelated to CF) or chronic obstructive pulmonary disease (COPD) can aerosolize P. aeruginosa during coughing and (ii) if genetically indistinguishable (shared) P. aeruginosa strains are present in these disease cohorts. Methods People with bronchiectasis or COPD and P. aeruginosa respiratory infection were recruited for two studies. Aerosol s tudy: Participants ( n = 20) underwent cough testing using validated cough rigs to determine the survival of P. aeruginosa aerosols in the air over distance and duration. Genotyping study: P. aeruginosa sputum isolates ( n = 95) were genotyped using the iPLEX20SNP platform, with a subset subjected to the enterobacterial repetitive intergenic consensus polymerase chain reaction (ERIC‐PCR) assay to ascertain their genetic relatedness. Results Aerosol study: Overall, 7 of 20 (35%) participants released P. aeruginosa cough aerosols during at least one of the cough aerosol tests. These cough aerosols remained viable for 4 m from the source and for 15 min after coughing. The mean total aerosol count of P. aeruginosa at 2 m was two colony‐forming units. Typing study: No shared P. aeruginosa strains were identified. Conclusion Low viable count of P. aeruginosa cough aerosols and a lack of shared P. aeruginosa strains observed suggest that aerosol transmission of P. aeruginosa is an unlikely mode of respiratory infection spread in patients with bronchiectasis and COPD.