Fatores determinantes das bronquiectasias não fibrocísticas em pacientes do sul do Brasil: estudo piloto
Conteúdo do artigo principal
Resumo
Introdução: A bronquiectasia é uma doença respiratória crônica que está amplamente relacionada a processos inflamatórios, dilatação irreversível dos brônquios e presença de infecções pulmonares recorrentes. Além disso, a doença apresenta ampla variabilidade geográfica, prevalente e etiológica, impulsionando a necessidade de avaliações locais que visem compreender a doença e seu comportamento em diferentes regiões do mundo.
Objetivo: Realizar uma primeira abordagem do perfil de prevalência da doença no extremo sul do Brasil.
Método: Estudo censitário avaliando o perfil clínico, sociodemográfico e a prevalência de bronquiectasias em pacientes atendidos em um ambulatório de pneumologia de referência regional.
Resultado: Dos 95 pacientes elegíveis para o estudo, 21 foram classificados como bronquiectásicos por meio do diagnóstico tomográfico. A maioria dos pacientes era do sexo feminino (67%), caucasiana (86%) e com idade entre 61 e 80 anos (62%). Em relação às doenças e sintomas relatados pelos pacientes, foi possível identificar uma presença considerável de pacientes pós-tuberculose (40%). Além disso, a realização da vacinação pneumocócica também foi uma variável que apresentou diferença significativa, onde 55% dos pacientes diagnosticados não realizaram a vacinação.
Conclusão: Este estudo permite o desenvolvimento de um estudo de base populacional, orientando políticas de saúde que favoreçam o acompanhamento e a qualidade de vida desses pacientes.
Detalhes do artigo

Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
Referências
Chalmers JD, Aliberti S, Blasi F. Management of bronchiectasis in adults. European Respiratory Journal. 2015;45(5):1446-62. https://doi.org/10.1183/13993003.01126-2025
Amati F, Simonetta E, Gramegna A, Tarsia P, Contarini M, Blasi F, et al. The biology of pulmonary exacerbations in bronchiectasis. European Respiratory Review. 2019;28(154):190055. https://doi.org/10.1183/16000617.0055-2019
Aliberti S, Sotgiu G, lapi F, Gramegna A, Cricelli C, Blasi F. Prevalence and incidence of bronchiectasis in Italy. BMC Pulmonary. 2020;20(1):15. https://doi.org/10.1186/s12890-020-1050-0
De la Rosa D, Garcia MAM, Olveira C, Girón R, Máiz L, Prados C. Annual direct medical costs of bronchiectasis treatment. Chronic Respiratory Disease. 2016;13(4):361-71. https://doi.org/10.1177/1479972316643698
Diel R, Ewig S, Blaas S, Jacob C, Juelich F, Korfmann G, et al. Incidence of patients with non-cystic fibrosis bronchiectasis in Germany – A healthcare insurance claims data analysis. Respiratory Medicine. 2018;151:121-7. https://doi.org/10.1016/j.rmed.2019.04.007
Monteagudo M, Blanco TR, Barrecheguren M, Simonet P, Miravitlles M. Prevalence and incidence of bronchiectasis in Catalonia, Spain: A population-based study. Respiratory Medicine. 2016;121:26-31. https://doi.org/10.1016/j.rmed.2016.10.014
Quint JK, Millett ERC, Joshi M, Navaratnam V, Thomas SL, Hurst JR, et al. Changes in the incidence, prevalence and mortality of bronchiectasis in the UK from 2004 to 2013: A population-based cohort study. European Respiratory Journal. 2016;47(1):186-93. https://doi.org/10.1183/13993003.01033-2015
Qin L, Carvalho FG, Xia Y, Zha J, Admetlló M, Maiques JM, et al. Profile of Clinical and Analytical Parameters in Bronchiectasis Patients during the COVID-19 Pandemic: A One-Year Follow-Up Pilot Study. Journal of Clinical Medicine. 2022;11(6):1727. https://doi.org/10.3390/jcm11061727
Wang H, Ji XB, Li CW, Lu HW, Mao B, Liang S, et al. Clinical characteristics and validation of bronchiectasis severity score systems for post-tuberculosis bronchiectasis. Clinical Respiratory Journal. 2018;12(8):2346-53. https://doi.org/10.1111/crj.12911
Einarsson GG, Comer DM, McIlreavey L, Parkhill J, Ennis M, Tunney MM, et al. Community dynamics and the lower airway microbiota in stable chronic obstructive pulmonary disease, smokers and healthy non-smokers. Thorax. 2016;71(9):795-803. https://doi.org/10.1136/thoraxjnl-2015-207235
Honarbakhsh S, Taylor GP. High prevalence of bronchiectasis is linked to HTLV-1-associated inflammatory disease. BMC Infectious Diseases. 2015;15(1):258. https://doi.org/10.1186/s12879-015-1002-0
Méndez R, Amara I, Menéndez R. Bronchiectasis and Multidrug-resistant Microorganisms:The Ideal Niche? Arch Bronconeumol. 2018;54(11):543-4. https://doi.org/10.1016/j.arbres.2018.02.018
Purcell P, Jary H, Perry A, Perry JD, Stewart CJ, Nelson A, et al. Polymicrobial airway bacterial communities in adult bronchiectasis patients. BMC Microbiology. 2014;14(1):130. https://doi.org/10.1186/1471-2180-14-130
Rogers GB, Zain NMM, Bruce KD, Burr LD, Chen AC, Rivett DW, et al. A novel microbiota stratification system predicts future exacerbations in bronchiectasis. Annals of the American Thoracic Society. 2014;11(4):496-503. https://doi.org/10.1513/annalsats.201310-335oc
Rogers GB, Van Der Gast CJ, Serisier DJ. Predominant pathogen competition and core microbiota divergence in chronic airway infection. ISME Journal. 2015;9(1):217-25. https://doi.org/10.1038/ismej.2014.124
Chandrasekaran R, Aogáin MM, Chalmers JD, Elborn SJ, Chotirmall SH. Geographic variation in the aetiology, epidemiology and microbiology of bronchiectasis. BMC Pulmonary Medicine. 2018;18(1):83. https://doi.org/10.1186/s12890-018-0638-0
Mcdonell MJ, Aliberti S, Goeminne PC, Dimakou K, Zucchetti SC, Davidson J, et al. Multidimensional severity assessment in bronchiectasis: An analysis of seven European cohorts. Thorax. 2016;71:1110-8. https://doi.org/10.1136/thoraxjnl-2016-208481
Figueiredo MR, Lomonaco I, Araújo AS, Lundgren F, Pereira EDB. Isolation of and risk factors for airway infection with pseudomonas aeruginosa in patients with non-cystic fibrosis bronchiectasis. Jornal Brasileiro de Pneumologia. 2021;47(3):e20210017. https://doi.org/10.36416/1806-3756/e20210017
Junior NSF, Abad MSC, Salcedo PS, Torres JP, Alcaide AB, Seijo LM, et al. Prevalence and burden of bronchiectasis in a lung cancer screening program. PLoS ONE. 2017;12(10):e0231204. https://doi.org/10.1371/journal.pone.0231204
Olm MAK, Marson FAL, Athanazio RA, Nakagawa NK, Macchione M, Loges NT, et al. Severe pulmonary disease in an adult primary ciliary dyskinesia population in Brazil. Scientific Reports. 2019;9(1):8693. https://doi.org/10.1038/s41598-019-45017-1
Machado BC, Jacques PS, Penteado LP, Dalcin PTR. Prognostic Factors in Adult Patients with Non-Cystic Fibrosis Bronchiectasis. Lung. 2018;196(6):691-7. https://doi.org/10.1007/s00408-018-0165-z
Biatobock D, Paz MSM, Olmedo DWV, Barlem ELD, Ramos DF. Bronquiectasias: morbilidad y mortalidad en Brasil y su impacto en las tasas de hospitalización. Rev. Soc. cient. Parag. 2022;27(1):61-73. https://doi.org/10.32480/rscp.2022.27.1.61
Malta DC, Moura L, Prado RR, Escalante JC, Schmidt MI, Duncan BB. Mortalidade por doenças crônicas não transmissíveis no Brasil e suas regiões, 2000 a 2011. Epidemiologia e Serviços de Saúde. 2014;23(4):599-608. https://doi.org/10.5123/S1679-49742014000400002
Marostica PJC, Fischer GB. Non-cystic-fibrosis bronchiectasis: A perspective from South America. Paediatric Respiratory Reviews. 2006;7(4):275-80. https://doi.org/10.1016/j.prrv.2006.04.008
Padilla-Galo A, Olveira C, Garcia LFR, Galve IM, Plata AJ, Alvarez A, et al. Factors associated with bronchiectasis in patients with uncontrolled asthma; the NOPES score: A study in 398 patients. Respiratory Research. 2018;19(1):43. https://doi.org/10.1186/s12931-018-0746-7
Olmedo DWV, Martins KB, Paz MM, Fernandes CLF, Silva Junior FMR, Ramos DF. Mutagenic damage among bronchiectasis patients attending in the pulmonology sector of a hospital in southern Brazil. Rev. Assoc. Med. Bras. 2022;68(9):1191-8. https://doi.org/10.1590/1806-9282.20220178
Goudouris ES, Mariz FP, Mendonça LO, Aranda CS, Guimarães RR, Kokron C, et al. Outcome of SARS-CoV-2 Infection in 121 Patients with Inborn Errors of Immunity: A Cross-Sectional Study. Journal of Clinical Immunology. 2021;41(7):1479-89. https://doi.org/10.1007/s10875-021-01066-8
World Health Organization. Global tuberculosis report 2023. https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2023.
Martins KB, Olmedo DWV, Paz MM, Ramos DF. Staphylococcus aureus and its Effects on the Prognosis of Bronchiectasis. Microb Drug Resist. 2021;27(6):823-34. https://doi.org/10.1089/mdr.2020.0352
Metersky ML, Aksamit TR, Barker A, Choate R, Daley CL, Daniels LA, et al. The prevalence and significance of Staphylococcus aureus in patients with non-cystic fibrosis bronchiectasis. Annals of the American Thoracic Society.2018;15(3):365-70. https://doi.org/10.1513/annalsats.201706-426oc
Somayaji R, Ramos KJ, Hoffman LR. Understanding the role of Staphylococcus aureus in non-cystic fibrosis bronchiectasis: Where are we now? Annals of the American Thoracic Society. 2018;15(3):310-1. https://doi.org/10.1513/annalsats.201712-944ed
Sahuquillo-Arce J, Cabezas AH, Méndez R, Menéndez R. Non-cystic fibrosis bronchiectasis: The long road to multidrug resistant bacteria. Community Acquired Infection. 2016;3(4):110-7.
Pereira MC, Athanazio RA, Dalcin PTR, Figueiredo MRF, Gomes M, Freitas CG, et al. Consenso brasileiro sobre bronquiectasias não fibrocísticas. Jornal Brasileiro de Pneumologia. Jornal Brasileiro de Pneumologia. 2019;45(4):e20190122. http://dx.doi.org/10.1590/1806-3713/e20190122
Mccallion P, De Soyza A. Cough and bronchiectasis. Pulmonary Pharmacology and Therapeutics. 2017;47:77-83. https://doi.org/10.1016/j.pupt.2017.04.010
Hurst JR, Elborn JS, Soyza A. COPD-bronchiectasis overlap syndrome. European Respiratory Journal. 2015;45(2):310-3. https://doi.org/10.1183/09031936.00170014
Lee AL, Burge AT, Holland AE. Airway clearance techniques for bronchiectasis. Cochrane Database of Systematic Reviews. 2015;(11):CD008351. https://doi.org/10.1002/14651858.cd008351.pub3








