{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T04:06:29Z","timestamp":1772165189715,"version":"3.50.1"},"reference-count":18,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Respir Dis"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Bronchiectasis exacerbations are a significant contributor to morbidity and mortality. While environmental factors, such as viral infections, are well-established triggers for exacerbations, the role of intrinsic factors, particularly chronic bacterial infections, remains incompletely understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>In this context, we sought to investigate the impact of chronic bacterial infections using the COVID-19 pandemic as a natural experiment, providing a unique opportunity to assess the effects of reduced external infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A retrospective observational cohort study was conducted involving patients with non-cystic fibrosis bronchiectasis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Data were collected via telephone interviews and medical record reviews, comparing exacerbation rates before (2019) and during (2020) the pandemic. The difference in exacerbation rates between 2020 and 2019 (delta exacerbations) served as the dependent variable in a multiple regression model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Sixty-three patients were included in the analysis. Those without chronic bacterial infections showed a significant reduction in exacerbations during the pandemic: mean (SD) was 1.06 (1.3) versus 1.61 (1.3), respectively (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      -value\u2009=\u20090.006). In contrast, no such reduction was observed in patients with chronic bacterial infections. Notably, chronic infection with\n                      <jats:italic toggle=\"yes\">Pseudomonas aeruginosa<\/jats:italic>\n                      emerged as an independent predictor of sustained or increased exacerbations in 2020 (positive delta exacerbations), despite the implementation of social distancing measures.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>\n                      While social distancing effectively reduced bronchiectasis exacerbations in patients without chronic bacterial infections, those with\n                      <jats:italic toggle=\"yes\">Pseudomonas aeruginosa<\/jats:italic>\n                      infections remained vulnerable to exacerbations, underscoring the importance of intrinsic disease\/host factors. These findings highlight the need for targeted management strategies addressing chronic infections in patients with bronchiectasis.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17534666251376501","type":"journal-article","created":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T09:58:51Z","timestamp":1761991131000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Unveiling the causes of bronchiectasis exacerbations: insights from a single-center study"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-6856-7319","authenticated-orcid":false,"given":"Martina","family":"Lo Casto","sequence":"first","affiliation":[{"name":"Division of Respiratory Diseases, Department of Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza \u201cG. D\u2019Alessandro\u201d - PROMISE \u2013 University of Palermo; Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlo","family":"Chessari","sequence":"additional","affiliation":[{"name":"Division of Respiratory Diseases, Department of Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza \u201cG. D\u2019Alessandro\u201d - PROMISE \u2013 University of Palermo; Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefania","family":"Marino","sequence":"additional","affiliation":[{"name":"Division of Respiratory Diseases, Department of Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza \u201cG. D\u2019Alessandro\u201d - PROMISE \u2013 University of Palermo; Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Fulvia","family":"Di Grado","sequence":"additional","affiliation":[{"name":"Division of Respiratory Diseases, Department of Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza \u201cG. D\u2019Alessandro\u201d - PROMISE \u2013 University of Palermo; Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna Isabella","family":"Memmo","sequence":"additional","affiliation":[{"name":"Division of Respiratory Diseases, Department of Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza \u201cG. D\u2019Alessandro\u201d - PROMISE \u2013 University of Palermo; Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7277-699X","authenticated-orcid":false,"given":"Stefania","family":"Principe","sequence":"additional","affiliation":[{"name":"Division of Respiratory Diseases; Department of Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza \u201cG. D\u2019Alessandro\u201d \u2013 PROMISE \u2013 University of Palermo; Palermo, Italy"},{"name":"Amsterdam UMC, Department of Respiratory Medicine \u2013 Amsterdam, University of Amsterdam, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6400-6573","authenticated-orcid":false,"given":"Nicola","family":"Scichilone","sequence":"additional","affiliation":[{"name":"Division of Respiratory Diseases, Department of Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza \u201cG. D\u2019Alessandro\u201d - PROMISE \u2013 University of Palermo; Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2867-917X","authenticated-orcid":false,"given":"Salvatore","family":"Battaglia","sequence":"additional","affiliation":[{"name":"Division of Respiratory Diseases, Dipartimento di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza \u201cG. D\u2019Alessandro\u201d (PROMISE), University of Palermo, Piazza delle Cliniche n. 2, Palermo 90127, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,11]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00051-2017"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00003709"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arbres.2022.09.004"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201309-1575OC"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/resp.12832"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/1753466621995043"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202105-1137LE"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40001-021-00539-1"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2021-217981"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202107-1731ED"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00629-2017"},{"key":"e_1_3_4_14_2","article-title":"Impact of the SARS-CoV-2 Virus Pandemic on Patients with Bronchiectasis: A Multicenter Study","volume":"11","author":"Martinez-Vergara A","year":"2022","unstructured":"Martinez-Vergara A, Giron Moreno RM, Olveira C, et al. Impact of the SARS-CoV-2 Virus Pandemic on Patients with Bronchiectasis: A Multicenter Study. 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