{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T21:59:35Z","timestamp":1772056775575,"version":"3.50.1"},"reference-count":45,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T00:00:00Z","timestamp":1638835200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1080298, 1045157, 1040830"],"award-info":[{"award-number":["1080298, 1045157, 1040830"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>We describe the prevalence and risk factors for protracted bacterial bronchitis (PBB) following healthcare presentation for an acute cough illness in children. Data from three studies of the development of chronic cough (CC) in children were combined. PBB was defined as a wet cough of at least 4-weeks duration with no identified specific cause of cough that resolved following 2\u20134 weeks of appropriate antibiotics. Anterior nasal swabs were tested for 17 viruses and bacteria by polymerase chain reaction. The study included 903 children. Childcare attendance (adjusted relative risk (aRR) = 2.32, 95% CI 1.48\u20133.63), prior history of chronic cough (aRR = 2.63, 95% CI 1.72\u20134.01) and age &lt;2-years (&lt;12-months: aRR = 4.31, 95% CI 1.42\u201313.10; 12-&lt;24 months: aRR = 2.00, 95% CI 1.35\u20132.96) increased risk of PBB. Baseline diagnoses of asthma\/reactive airways disease (aRR = 0.30, 95% CI 0.26\u20130.35) or bronchiolitis (aRR = 0.15, 95% CI 0.06\u20130.38) decreased risk. M. catarrhalis was the most common organism (52.4%) identified in all children (PBB = 72.1%; no PBB = 50.2%, p &lt; 0.001). We provide the first data on risks for PBB in children following acute illness and a hypothesis for studies to further investigate the relationship with wheeze-related illnesses. Clinicians and parents\/guardians should be aware of these risks and seek early review if a wet cough lasting more than 4-weeks develops the post-acute illness.<\/jats:p>","DOI":"10.3390\/jcm10245735","type":"journal-article","created":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T20:23:21Z","timestamp":1638908601000},"page":"5735","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Predictors of the Development of Protracted Bacterial Bronchitis following Presentation to Healthcare for an Acute Respiratory Illness with Cough: Analysis of Three Cohort Studies"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8159-2620","authenticated-orcid":false,"given":"Kerry-Ann F.","family":"O\u2019Grady","sequence":"first","affiliation":[{"name":"Australian Centre for Health Services Innovation, Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD 4059, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juliana","family":"Mahon","sequence":"additional","affiliation":[{"name":"School of Public Health & Social Work, Queensland University of Technology, Brisbane, QLD 4059, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Arnold","sequence":"additional","affiliation":[{"name":"Australian Centre for Health Services Innovation, Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD 4059, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keith","family":"Grimwood","sequence":"additional","affiliation":[{"name":"NHMRC Centre for Research Excellence in Paediatric Bronchiectasis, School of Medicine and Dentistry, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD 4222, Australia"},{"name":"Departments of Infectious Disease and Paediatrics, Gold Coast Health, Gold Coast, QLD 4215, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kerry K.","family":"Hall","sequence":"additional","affiliation":[{"name":"First Peoples Health Unit, School of Medicine and Dentistry, Griffith University, Gold Coast, QLD 4215, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vikas","family":"Goyal","sequence":"additional","affiliation":[{"name":"Australian Centre for Health Services Innovation, Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD 4059, Australia"},{"name":"NHMRC Centre for Research Excellence in Paediatric Bronchiectasis, Department of Respiratory Medicine, Queensland Children\u2019s Hospital, Brisbane, QLD 4101, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie M.","family":"Marchant","sequence":"additional","affiliation":[{"name":"Australian Centre for Health Services Innovation, Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD 4059, Australia"},{"name":"NHMRC Centre for Research Excellence in Paediatric Bronchiectasis, Department of Respiratory Medicine, Queensland Children\u2019s Hospital, Brisbane, QLD 4101, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalie","family":"Phillips","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Queensland Children\u2019s Hospital, Brisbane, QLD 4101, Australia"},{"name":"Child Health Research Centre, University of Queensland, Brisbane, QLD 4101, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Acworth","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Queensland Children\u2019s Hospital, Brisbane, QLD 4101, Australia"},{"name":"Faculty of Medicine, University of Queensland, Brisbane, QLD 4072, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex","family":"King","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, The Toowoomba Hospital, Toowoomba, QLD 4350, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Scott","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Caboolture Hospital, Caboolture, QLD 4510, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1331-3706","authenticated-orcid":false,"given":"Anne B.","family":"Chang","sequence":"additional","affiliation":[{"name":"Australian Centre for Health Services Innovation, Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD 4059, Australia"},{"name":"NHMRC Centre for Research Excellence in Paediatric Bronchiectasis, Department of Respiratory Medicine, Queensland Children\u2019s Hospital, Brisbane, QLD 4101, Australia"},{"name":"Menzies School of Health Research, Charles Darwin University, Tiwi, NT 0810, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1378\/chest.129.5.1132","article-title":"Evaluation and outcome of young children with chronic cough","volume":"129","author":"Marchant","year":"2006","journal-title":"Chest"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1602139","DOI":"10.1183\/13993003.02139-2016","article-title":"ERS statement on protracted bacterial bronchitis in children","volume":"50","author":"Kantar","year":"2017","journal-title":"Eur. Respir. J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1002\/ppul.20821","article-title":"Chronic wet cough: Protracted bronchitis, chronic suppurative lung disease and bronchiectasis","volume":"43","author":"Chang","year":"2008","journal-title":"Pediatr. Pulmonol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1016\/S0140-6736(18)31554-X","article-title":"Bronchiectasis in children: Diagnosis and treatment","volume":"392","author":"Chang","year":"2018","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Drescher, B.J., Chang, A.B., Phillips, N., Acworth, J., Marchant, J., Sloots, T.P., David, M., and O\u2019Grady, K.A. (2013). The development of chronic cough in children following presentation to a tertiary paediatric emergency department with acute respiratory illness: Study protocol for a prospective cohort study. BMC Pediatr., 13.","DOI":"10.1186\/1471-2431-13-125"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1044","DOI":"10.1136\/archdischild-2017-312848","article-title":"Chronic cough postacute respiratory illness in children: A cohort study","volume":"102","author":"Drescher","year":"2017","journal-title":"Arch. Dis. Child."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Hall, K.K., Chang, A.B., Sloots, T.P., Anderson, J., Kemp, A., Hammill, J., Otim, M., and O\u2019Grady, K.A. (2015). The respiratory health of urban indigenous children aged less than 5 years: Study protocol for a prospective cohort study. BMC Pediatr., 15.","DOI":"10.1186\/s12887-015-0375-y"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"228","DOI":"10.3389\/fped.2017.00228","article-title":"The Incidence and Short-term Outcomes of Acute Respiratory Illness with Cough in Children from a Socioeconomically Disadvantaged Urban Community in Australia: A Community-Based Prospective Cohort Study","volume":"5","author":"Hall","year":"2017","journal-title":"Front. Pediatr."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e013796","DOI":"10.1136\/bmjopen-2016-013796","article-title":"Effectiveness of a cough management algorithm at the transitional phase from acute to chronic cough in Australian children aged <15 years: Protocol for a randomised controlled trial","volume":"7","author":"Grimwood","year":"2017","journal-title":"BMJ Open"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1016\/S2352-4642(19)30327-X","article-title":"Effectiveness of a chronic cough management algorithm at the transitional stage from acute to chronic cough in children: A multicenter, nested, single-blind, randomised controlled trial","volume":"3","author":"Grimwood","year":"2019","journal-title":"Lancet Child Adolesc. Health"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"265","DOI":"10.5694\/j.1326-5377.2010.tb03504.x","article-title":"CICADA: Cough in Children and Adults: Diagnosis and Assessment. Australian cough guidelines summary statement","volume":"192","author":"Gibson","year":"2010","journal-title":"Med. J. Aust."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1016\/j.chest.2017.06.006","article-title":"Etiologies of Chronic Cough in Pediatric Cohorts: CHEST Guideline and Expert Panel Report","volume":"152","author":"Chang","year":"2017","journal-title":"Chest"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e1576","DOI":"10.1542\/peds.2012-3318","article-title":"A cough algorithm for chronic cough in children: A multicenter, randomized controlled study","volume":"131","author":"Chang","year":"2013","journal-title":"Pediatrics"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1378\/chest.08-0885","article-title":"Evaluation of chronic cough in children","volume":"134","author":"Asilsoy","year":"2008","journal-title":"Chest"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Lau, G.T.Y., Laird, P., Stevenson, P.G., and Schultz, A. (2021). Frequency of protracted bacterial bronchitis and management pre-respiratory referral. J. Paediatr. Child Health, online ahead of print.","DOI":"10.1111\/jpc.15665"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1186\/s13052-015-0180-0","article-title":"Evaluation of 563 children with chronic cough accompanied by a new clinical algorithm","volume":"41","author":"Gedik","year":"2015","journal-title":"Ital. J. Pediatr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1378\/chest.11-2725","article-title":"A multi-centre study on chronic cough in children: Burden and etiologies based on a standardized management pathway","volume":"142","author":"Chang","year":"2012","journal-title":"Chest"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1136\/archdischild-2012-302760","article-title":"Protracted bacterial bronchitis: Reinventing an old disease","volume":"98","author":"Craven","year":"2012","journal-title":"Arch. Dis. Child."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"444","DOI":"10.3389\/fped.2020.00444","article-title":"Risk Factors for Chronic Cough in Young Children: A Cohort Study","volume":"8","author":"Chang","year":"2020","journal-title":"Front. Pediatr."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1378\/chest.13-2442","article-title":"Prospective characterization of protracted bacterial bronchitis in children","volume":"145","author":"Wurzel","year":"2014","journal-title":"Chest"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1002\/ppul.23351","article-title":"Protracted bacterial bronchitis: The last decade and the road ahead","volume":"51","author":"Chang","year":"2016","journal-title":"Pediatr. Pulmonol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1002\/ppul.23541","article-title":"Misdiagnosis of asthma in schoolchildren","volume":"52","author":"Yang","year":"2017","journal-title":"Pediatr. Pulmonol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"00348-2019","DOI":"10.1183\/23120541.00348-2019","article-title":"Defining asthma in children: How well do parents, doctors and spirometry agree?","volume":"6","author":"Korsten","year":"2020","journal-title":"ERJ Open Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"148","DOI":"10.3389\/fped.2019.00148","article-title":"Approaches to Asthma Diagnosis in Children and Adults","volume":"7","author":"Saglani","year":"2019","journal-title":"Front. Pediatr."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"260S","DOI":"10.1378\/chest.129.1_suppl.260S","article-title":"Guidelines for evaluating chronic cough in pediatrics: ACCP evidence-based clinical practice guidelines","volume":"129","author":"Chang","year":"2006","journal-title":"Chest"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1056\/NEJM197503132921103","article-title":"Exertional dyspnea and cough as preludes to acute attacks of bronchial asthma","volume":"292","author":"McFadden","year":"1975","journal-title":"N. Engl. J. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.chest.2020.01.042","article-title":"Managing Chronic Cough as a Symptom in Children and Management Algorithms: CHEST Guideline and Expert Panel Report","volume":"158","author":"Chang","year":"2020","journal-title":"Chest"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1111\/j.1440-1754.2008.01433.x","article-title":"Asthma and protracted bronchitis: Who fares better during an acute respiratory infection?","volume":"45","author":"Petsky","year":"2009","journal-title":"J. Paediatr. Child Health"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1378\/chest.14-0131","article-title":"Mediators of neutrophil function in children with protracted bacterial bronchitis","volume":"146","author":"Baines","year":"2014","journal-title":"Chest"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1016\/j.chest.2015.10.066","article-title":"Is Alveolar Macrophage Phagocytic Dysfunction in Children With Protracted Bacterial Bronchitis a Forerunner to Bronchiectasis?","volume":"149","author":"Hodge","year":"2016","journal-title":"Chest"},{"key":"ref_31","first-page":"010401","article-title":"Epidemiology and etiology of childhood pneumonia in 2010: Estimates of incidence, severe morbidity, mortality, underlying risk factors and causative pathogens for 192 countries","volume":"3","author":"Rudan","year":"2013","journal-title":"J. Glob. Health"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"218","DOI":"10.3389\/fped.2020.00218","article-title":"Time to Say Goodbye to Bronchiolitis, Viral Wheeze, Reactive Airways Disease, Wheeze Bronchitis and All That","volume":"8","author":"Douros","year":"2020","journal-title":"Front. Pediatr."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1007\/s00431-017-3044-3","article-title":"Bacteria from bronchoalveolar lavage fluid from children with suspected chronic lower respiratory tract infection: Results from a multi-center, cross-sectional study in Spain","volume":"177","author":"Feng","year":"2018","journal-title":"Eur. J. Pediatr."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1002\/ppul.24336","article-title":"Do combined upper airway cultures identify lower airway infections in children with chronic cough?","volume":"54","author":"Hare","year":"2019","journal-title":"Pediatr. Pulmonol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1086\/599375","article-title":"Moraxella catarrhalis, a human respiratory tract pathogen","volume":"49","author":"Murphy","year":"2009","journal-title":"Clin. Infect. Dis."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Ngo, C.C., Massa, H.M., Thornton, R.B., and Cripps, A.W. (2016). Predominant Bacteria Detected from the Middle Ear Fluid of Children Experiencing Otitis Media: A Systematic Review. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0150949"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1164\/rccm.200412-1747OC","article-title":"Moraxella catarrhalis in chronic obstructive pulmonary disease: Burden of disease and immune response","volume":"172","author":"Murphy","year":"2005","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"213","DOI":"10.3389\/fcimb.2020.00213","article-title":"Bacterial Community Interactions During Chronic Respiratory Disease","volume":"10","author":"Welp","year":"2020","journal-title":"Front. Cell Infect. Microbiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"433","DOI":"10.3389\/fped.2020.00433","article-title":"When the Cough Does Not. Improve: A Review on Protracted Bacterial Bronchitis in Children","volume":"8","author":"Gallucci","year":"2020","journal-title":"Front. Pediatr."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1002\/ppul.23527","article-title":"Upper airway viruses and bacteria and clinical outcomes in children with cough","volume":"52","author":"Grimwood","year":"2017","journal-title":"Pediatr. Pulmonol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/S2352-4642(17)30019-6","article-title":"Asthma diagnosis in children: More evidence needed","volume":"1","author":"Latzin","year":"2017","journal-title":"Lancet Child Adolesc. Health"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1378\/chest.07-2236","article-title":"What is the burden of chronic cough for families?","volume":"134","author":"Marchant","year":"2008","journal-title":"Chest"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1007\/s11136-017-1779-y","article-title":"Longitudinal study of quality of life among children with acute respiratory infection and cough","volume":"27","author":"Chang","year":"2018","journal-title":"Qual. Life Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2707","DOI":"10.1002\/ppul.25438","article-title":"Chronic wet cough in Australian children: Societal costs and quality of life","volume":"56","author":"Prime","year":"2021","journal-title":"Pediatr. Pulmonol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1111\/resp.13950","article-title":"Outcomes of protracted bacterial bronchitis in children: A 5-year prospective cohort study","volume":"26","author":"Ruffles","year":"2021","journal-title":"Respirology"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/24\/5735\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:42:52Z","timestamp":1760168572000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/24\/5735"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,7]]},"references-count":45,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["jcm10245735"],"URL":"https:\/\/doi.org\/10.3390\/jcm10245735","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,7]]}}}