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dc.contributor.authorWurzel, Danielle F
dc.contributor.authorMarchant, Julie M
dc.contributor.authorYerkovich, Stephanie T
dc.contributor.authorUpham, John W
dc.contributor.authorPetsky, Helen L
dc.contributor.authorSmith-Vaughan, Heidi
dc.contributor.authorMasters, Brent
dc.contributor.authorBuntain, Helen
dc.contributor.authorChang, Anne B
dc.date.accessioned2017-12-19T01:37:44Z
dc.date.available2017-12-19T01:37:44Z
dc.date.issued2016
dc.identifier.issn0012-3692
dc.identifier.doi10.1016/j.chest.2016.06.030
dc.identifier.urihttp://hdl.handle.net/10072/124058
dc.description.abstractBACKGROUND: Protracted bacterial bronchitis (PBB) and bronchiectasis are distinct diagnostic entities that share common clinical and laboratory features. It is postulated, but remains unproved, that PBB precedes a diagnosis of bronchiectasis in a subgroup of children. In a cohort of children with PBB, our objectives were to (1) determine the medium-term risk of bronchiectasis and (2) identify risk factors for bronchiectasis and recurrent episodes of PBB. METHODS: One hundred sixty-one children with PBB and 25 control subjects were prospectively recruited to this cohort study. A subset of 106 children was followed for 2 years. Flexible bronchoscopy, BAL, and basic immune function tests were performed. Chest CT was undertaken if clinical features were suggestive of bronchiectasis. RESULTS: Of 161 children with PBB (66% boys), 13 were diagnosed with bronchiectasis over the study period (8.1%). Almost one-half with PBB (43.5%) had recurrent episodes (> 3/y). Major risk factors for bronchiectasis included lower airway infection with Haemophilus influenzae (recovered in BAL fluid) (P ¼ .013) and recurrent episodes of PBB (P ¼ .003). H influenzae infection conferred a more than seven times higher risk of bronchiectasis (hazard ratio, 7.55; 95% CI, 1.66-34.28; P ¼ .009) compared with no H influenzae infection. The majority of isolates (82%) were nontypeable H influenzae. No risk factors for recurrent PBB were identified. CONCLUSIONS: PBB is associated with a future diagnosis of bronchiectasis in a subgroup of children. Lower airway infection with H influenzae and recurrent PBB are significant predictors. Clinicians should be cognizant of the relationship between PBB and bronchiectasis, and appropriate follow-up measures should be taken in those with risk factors.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherElsevier
dc.relation.ispartofpagefrom1101
dc.relation.ispartofpageto1108
dc.relation.ispartofissue5
dc.relation.ispartofjournalChest
dc.relation.ispartofvolume150
dc.subject.fieldofresearchRespiratory Diseases
dc.subject.fieldofresearchClinical Sciences
dc.subject.fieldofresearchcode110203
dc.subject.fieldofresearchcode1103
dc.titleProtracted Bacterial Bronchitis in Children: Natural History and Risk Factors for Bronchiectasis
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
gro.hasfulltextNo Full Text
gro.griffith.authorSmith-Vaughan, Heidi
gro.griffith.authorPetsky, Helen


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