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Outcomes of protracted bacterial bronchitis in children: A 5-year prospective cohort study

Tom J C Ruffles1,2, Julie M Marchant1, Ian B Masters1

  • 1Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Centre for Children's Health Research, Queensland University of Technology, Brisbane, QLD, Australia.

Respirology (Carlton, Vic.)
|October 12, 2020
PubMed

Insights

Many children with pneumonia with biphasic Беларусі (PBB) experience ongoing symptoms, including bronchiectasis and asthma, 5 years later. Recurrent PBB and Haemophilus influenzae infection predict bronchiectasis, while allergies predict asthma.

Area of Science:

  • Pediatric Respiratory Medicine
  • Clinical Outcomes Research
  • Chronic Lung Disease

Background:

  • Persistent Pulmonary Bleeding (PBB) in children necessitates long-term outcome research.
  • Identifying chronic respiratory diseases and their risk factors following PBB is a priority.

Purpose of the Study:

  • To describe the 5-year outcomes for children diagnosed with PBB.
  • To identify risk factors for chronic respiratory diseases such as bronchiectasis and asthma post-PBB.

Main Methods:

  • A prospective cohort study involving 166 children with PBB and 28 controls.
  • Monthly monitoring, clinical reviews, spirometry, and CT scans were utilized.
  • Follow-up duration was a median of 59 months.

Main Results:

  • 67.5% of children experienced ongoing symptoms; 9.6% developed bronchiectasis.
  • Recurrent PBB and Haemophilus influenzae in bronchoalveolar lavage (BAL) predicted bronchiectasis.
  • Asthma was diagnosed in 27.1% of children with PBB, predicted by positive allergen-specific IgE and bronchomalacia.

Conclusions:

  • A significant proportion of children with PBB have persistent symptoms, bronchiectasis, and asthma at 5 years.
  • Close clinical follow-up is essential for these children.
  • Further research into biomarkers, endotypes, and mechanisms is needed to understand diverse outcomes.
Abstract

Keywords:
asthmabronchiectasiscoughpaediatric lung diseaserespiratory infections (non-tuberculous)

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