Comparison of Clinical and Microbiological Features in Children with Protracted Bacterial Bronchitis and Bronchiectasis

Protracted bacterial bronchitis (PBB) and bronchiectasis (BE) are considered part of a spectrum of chronic suppurative airway diseases; yet, their clinical distinctions in children remain unclear. To compare the clinical, microbiological, and immunological characteristics of children with PBB and BE and to identify factors independently associated with bronchiectasis.

This cross-sectional study included 96 children (53 with PBB and 43 with BE). Demographic features, exacerbation frequency, spirometry results, vitamin D levels, microbiological findings, and comorbidities were analyzed. Multivariate logistic regression was performed to determine independent associations with BE.

Children with BE were significantly older than those with PBB (P < .001). The PBB group had a higher annual exacerbation frequency (P < .001), whereas spirometric parameters and the prevalence of asthma and atopy were similar between groups. Haemophilus influenzae was the most frequently isolated pathogen in both groups. In multivariate analysis, age was independently associated with BE (OR: 1.685, 95% CI: 1.202-2.361, P = .002), whereas exacerbation frequency was inversely associated (OR: 0.087, 95% CI: 0.022-0.342, P < .001). Vitamin D levels, asthma, and atopy were not significantly associated.

Protracted bacterial bronchitis and bronchiectasis share overlapping clinical and microbiological features; however, differences between groups may be partly explained by age. Higher exacerbation frequency in PBB may reflect age-related susceptibility to infections. Longitudinal studies are needed to clarify disease progression.