Chest
Original Research: BronchiectasisProtracted Bacterial Bronchitis in Children: Natural History and Risk Factors for Bronchiectasis
Section snippets
Study Participants
Participants were enrolled as part of a larger prospective cohort study aimed at evaluating the long-term outcomes of children with chronic cough. Written informed consent was obtained from all parents/guardians, and ethics approval was granted by The Queensland Children’s Health Services Human Research Ethics Committee (HREC/03/QRCH/17).
Between March 2008 and October 2012, 343 children were enrolled. Of them, 161 fulfilled criteria for PBB; 25 were recruited as control participants (15
Clinical and Demographic Characteristics of Participants
Of the 161 children with PBB, 106 completed the 2-year follow-up period and had clinician assessment for bronchiectasis (Fig 1). The median duration of follow-up was 25 months (IQR, 24-28) in children with PBB and 27 months (IQR, 26-29) in control subjects undergoing bronchoscopy.
There was no difference between children who completed the 2-year follow-up and those who did not (Table 1) with regard to duration of cough at recruitment (P = .807), H influenzae status (P = .518), or proportion of
Discussion
This is the first prospective longitudinal cohort study of children with PBB. In our cohort, which was based in a large tertiary pediatric hospital, almost 44% of subjects had recurrent episodes (more than three episodes in the first year after recruitment) and approximately one in 12 were diagnosed with bronchiectasis at 2 years. We identified two significant risk factors for bronchiectasis: recurrent (more than episodes 3 per year) PBB and the presence of H influenzae infection in the lower
Acknowledgments
Author contributions: D. F. W. co-conceptualized the study, is responsible for the content of the manuscript including data analysis and manuscript preparation, and was involved in data collection. J. M. M. co-conceptualized the study and contributed to data interpretation and manuscript preparation. S. T. Y. co-conceptualized the study, contributed to aspects of data analyses, and provided critical review of the manuscript. J. W. U. co-conceptualized the study and provided critical review of
References (40)
- et al.
Evaluation and outcome of young children with chronic cough
Chest
(2006) - et al.
Protracted bacterial bronchitis in young children: association with airway malacia
J Pediatr
(2012) - et al.
Prospective characterization of protracted bacterial bronchitis in children
Chest
(2014) - et al.
Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study
Lancet
(2012) - et al.
Bronchoarterial ratio on high-resolution CT scan of the chest in children without pulmonary pathology: need to redefine bronchial dilatation
Chest
(2011) - et al.
Non-typeable Haemophilus influenzae, an under-recognised pathogen
Lancet Infect Dis
(2014) - et al.
Longitudinal growth and lung function in pediatric non-cystic fibrosis bronchiectasis: what influences lung function stability?
Chest
(2010) - et al.
Reversible bronchial dilatation in children: comparison of serial high-resolution computer tomography scans of the lungs
Eur J Radiol
(2003) - et al.
A multicenter study on chronic cough in children: burden and etiologies based on a standardized management pathway
Chest
(2012) - et al.
Bronchiectasis: the arrival of better evidence
Lancet Respir Med
(2014)
A cough algorithm for chronic cough in children: a multicenter, randomized controlled study
Pediatrics
CICADA: Cough in Children and Adults: diagnosis and Assessment. Australian cough guidelines summary statement
Med J Aust
Anatomy and development of the respiratory system
Bronchoscopic findings in children with chronic wet cough
Pediatrics
BTS guidelines: recommendations for the assessment and management of cough in children
Thorax
Outcomes in children with protracted bacterial bronchitis confirmed by bronchoscopy
Arch Dis Child
Lower airway microbiology and cellularity in children with newly diagnosed non-CF bronchiectasis
Pediatr Pulmonol
Prospective assessment of protracted bacterial bronchitis: airway inflammation and innate immune activation
Pediatr Pulmonol
Innate immune activation in neutrophilic asthma and bronchiectasis
Thorax
Three clinically distinct chronic pediatric airway infections share a common core microbiota
Ann Am Thorac Soc
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FUNDING SUPPORT: This work was supported by the National Health and Medical Research Council (NHMRC) [project grant 1042601 and Centre of Research Excellence grant 1040830] and the Financial Markets Foundation for Children [project grant 2010-005]. D. W. was supported by scholarships from the Thoracic Society of Australia and New Zealand/Allen and Hanbury’s, Queensland Children’s Medical Research Institute and NHMRC [1039688]. A. C. and H. S. V. are supported by NHMRC fellowships [1058213 and 1024175]. The views expressed in this publication are those of the authors and do not reflect the views of the NHMRC.