{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T19:42:43Z","timestamp":1765827763037,"version":"build-2065373602"},"reference-count":31,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2019,3,6]],"date-time":"2019-03-06T00:00:00Z","timestamp":1551830400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Few data are available on chronic bacterial infections (CBI) in bronchiectasis patients. Given that CBI seems to trigger longer hospital stays, worse outcomes, and morbimortality, this study was undertaken to assess CBI prevalence, characteristics, and risk factors in outpatients with bronchiectasis. Methods: A total of 186 patients followed in a bronchiectasis tertiary referral centre in Portugal were included. Demographic data and information on aetiology, smoking history, mMRC score, Bronchiectasis Severity Index (BSI) score, sputum characteristics, lung function, exacerbations, and radiological involvement degree were collected. Results: Patients included (mean age 54.7 \u00b1 16.2 years; 60.8% females) were followed up for a period of 3.8 \u00b1 1.7 years. The most common cause of bronchiectasis was infection (31.7%) followed by immune deficiencies (11.8%), whereas in 29% of cases, no cause was identified. Haemophilus influenzae (32.3%) and Pseudomonas aeruginosa (30.1%) were the most common CBI-associated possible pathogenic microorganisms. CBI patients presented a higher follow-up time than no-CBI patients (p = 0.003), worse lung function, BSI (p &lt; 0.001), and radiological (p &lt; 0.001) scores, and more prominent daily sputum production (p = 0.002), estimated mean volume (p &lt; 0.001), and purulent sputum (p &lt; 0.001). The number of exacerbations\/year (p = 0.001), including those requiring hospital admission (p = 0.009), were also higher in the CBI group. Independent CBI predictors were BSI score (OR 3.577, 95% CI 1.233\u201310.378), sputum characteristics (OR 3.306, 95% CI 1.107\u20139.874), and radiological score (OR 1.052, 95% CI 1.004\u20131.102). Conclusion: According to the CBI status, two different sub-groups of patients were found on the basis of several clinical outcomes, emphasizing the importance of routine sputum microbiological monitoring. Further studies are needed to better characterize CBI profiles and to define the individual clinical impact of the most prevalent pathogenic microorganisms.<\/jats:p>","DOI":"10.3390\/jcm8030315","type":"journal-article","created":{"date-parts":[[2019,3,7]],"date-time":"2019-03-07T10:52:22Z","timestamp":1551955942000},"page":"315","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Chronic Bacterial Infection Prevalence, Risk Factors, and Characteristics: A Bronchiectasis Population-Based Prospective Study"],"prefix":"10.3390","volume":"8","author":[{"given":"Adelina","family":"Amorim","sequence":"first","affiliation":[{"name":"Pulmonology Department, Centro Hospitalar S. Jo\u00e3o, 4200-319 Porto, Portugal"},{"name":"Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"}]},{"given":"Leonor","family":"Meira","sequence":"additional","affiliation":[{"name":"Pulmonology Department, Centro Hospitalar S. Jo\u00e3o, 4200-319 Porto, Portugal"}]},{"given":"Margarida","family":"Redondo","sequence":"additional","affiliation":[{"name":"Pulmonology Department, Centro Hospitalar S. Jo\u00e3o, 4200-319 Porto, Portugal"}]},{"given":"Manuela","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Clinical Pathology Department, Centro Hospitalar S. Jo\u00e3o, 4200-319 Porto, Portugal"}]},{"given":"Ricardo","family":"Castro","sequence":"additional","affiliation":[{"name":"Radiology Department, Centro Hospitalar S. Jo\u00e3o, 4200-319 Porto, Portugal"}]},{"given":"M\u00e1rcio","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Radiology Department, Centro Hospitalar S. Jo\u00e3o, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5934-5201","authenticated-orcid":false,"given":"Nat\u00e1lia","family":"Martins","sequence":"additional","affiliation":[{"name":"Pulmonology Department, Centro Hospitalar S. Jo\u00e3o, 4200-319 Porto, Portugal"},{"name":"Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"Institute for Research and Innovation in Health (i3S), University of Porto, 4200-135 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6577-0063","authenticated-orcid":false,"given":"Venceslau","family":"Hespanhol","sequence":"additional","affiliation":[{"name":"Pulmonology Department, Centro Hospitalar S. Jo\u00e3o, 4200-319 Porto, Portugal"},{"name":"Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2019,3,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1378\/chest.08-0776","article-title":"Bronchiectasis","volume":"134","year":"2008","journal-title":"Chest"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1183\/20734735.007516","article-title":"Global impact of bronchiectasis and cystic fibrosis","volume":"12","author":"Redondo","year":"2016","journal-title":"Breathe"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1164\/ajrccm.162.4.9906120","article-title":"An investigation into causative factors in patients with bronchiectasis","volume":"162","author":"Pasteur","year":"2000","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1378\/chest.108.4.955","article-title":"Clinical, pathophysiologic, and microbiologic characterization of bronchiectasis in an aging cohort","volume":"108","author":"Nicotra","year":"1995","journal-title":"Chest"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1633","DOI":"10.1016\/j.rmed.2007.03.009","article-title":"Microbiologic follow-up study in adult bronchiectasis","volume":"101","author":"King","year":"2007","journal-title":"Respir. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1016\/j.rmed.2014.07.021","article-title":"De Non cystic fibrosis bronchiectasis: A longitudinal retrospective observational cohort study of Pseudomonas persistence and resistance","volume":"109","author":"McDonnell","year":"2015","journal-title":"Respir. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1136\/thoraxjnl-2012-203105","article-title":"Clinical measures of disease in adult non-CF bronchiectasis correlate with airway microbiota composition","volume":"68","author":"Rogers","year":"2013","journal-title":"Thorax"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2183","DOI":"10.1016\/j.rmed.2006.03.012","article-title":"Characterisation of the onset and presenting clinical features of adult bronchiectasis","volume":"100","author":"King","year":"2006","journal-title":"Respir. Med."},{"key":"ref_9","first-page":"1602","article-title":"A comprehensive analysis of the impact of pseudomonas aeruginosa colonization on prognosis in adult bronchiectasis","volume":"12","author":"Finch","year":"2015","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Ara\u00fajo, D., Shteinberg, M., Aliberti, S., Goeminne, P.C., Hill, A.T., Fardon, T.C., Obradovic, D., Stone, G., Trautmann, M., and Davis, A. (2018). The independent contribution of Pseudomonas aeruginosa infection to long-term clinical outcomes in bronchiectasis. Eur. Respir. J., 51.","DOI":"10.1183\/13993003.01953-2017"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1183\/13993003.01899-2015","article-title":"Clinical phenotypes in adult patients with bronchiectasis","volume":"47","author":"Aliberti","year":"2016","journal-title":"Eur. Respir. J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1164\/rccm.201309-1575OC","article-title":"The bronchiectasis severity index: An international derivation and validation study","volume":"189","author":"Chalmers","year":"2014","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_13","first-page":"222","article-title":"Recommendations for aetiological diagnosis of bronchiectasis","volume":"22","author":"Amorim","year":"2016","journal-title":"Rev. Port. Pneumol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1183\/09031936.00163208","article-title":"Sputum colour: A useful clinical tool in non-cystic fibrosis bronchiectasis","volume":"34","author":"Murray","year":"2008","journal-title":"Eur. Respir. J."},{"key":"ref_15","unstructured":"Clinical and Laboratory Standards Institute (CLSI) (2011). Performance Standards for Antimicrobial Susceptibility Testing, CLSI. Twenty-First Informational Supplement."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1183\/09031936.05.00035205","article-title":"Interpretative strategies for lung function tests","volume":"26","author":"Pellegrino","year":"2005","journal-title":"Eur. Respir. J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1183\/09031936.05.00034505","article-title":"General considerations for lung function testing","volume":"26","author":"Miller","year":"2005","journal-title":"Eur. Respir. J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1148\/radiology.179.3.2027992","article-title":"Cystic fibrosis: Scoring system with thin-section CT","volume":"179","author":"Bhalla","year":"1991","journal-title":"Radiology"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1424","DOI":"10.1378\/chest.130.5.1424","article-title":"Pulmonary abnormalities on high-resolution CT demonstrate more rapid decline than FEV1 in adults with cystic fibrosis","volume":"130","author":"Judge","year":"2006","journal-title":"Chest"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1164\/rccm.200604-571ST","article-title":"An Official ATS\/IDSA Statement: Diagnosis, Treatment, and Prevention of Nontuberculous Mycobacterial Diseases","volume":"175","author":"Griffith","year":"2007","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1183\/1025448x.10003610","article-title":"Microbiology of non-CF bronchiectasis","volume":"52","author":"Foweraker","year":"2011","journal-title":"Bronchiectasis"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1136\/thorax.57.1.15","article-title":"Bacterial colonisation in patients with bronchiectasis: Microbiological pattern and risk factors","volume":"57","author":"Angrill","year":"2002","journal-title":"Thorax"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Cox, M.J., Turek, E.M., Hennessy, C., Mirza, G.K., James, P.L., Coleman, M., Jones, A., Wilson, R., Bilton, D., and Cookson, W.O.C. (2017). Longitudinal assessment of sputum microbiome by sequencing of the 16S rRNA gene in non-cystic fibrosis bronchiectasis patients. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0170622"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1016\/j.rmed.2006.11.008","article-title":"Aetiology in adult patients with bronchiectasis","volume":"101","author":"Shoemark","year":"2007","journal-title":"Respir. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1164\/rccm.200501-124OC","article-title":"HLA-C and killer cell immunoglobulin-like receptor genes in idiopathic bronchiectasis","volume":"173","author":"Boyton","year":"2006","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.rmed.2012.10.024","article-title":"Chronic bronchial infection in COPD. Is there an infective phenotype?","volume":"107","author":"Matkovic","year":"2013","journal-title":"Respir. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1700051","DOI":"10.1183\/13993003.00051-2017","article-title":"Pulmonary exacerbation in adults with bronchiectasis: A consensus definition for clinical research","volume":"49","author":"Hill","year":"2017","journal-title":"Eur. Respir. J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1183\/09031936.00069007","article-title":"Mucosal inflammation in idiopathic bronchiectasis: Cellular and molecular mechanisms","volume":"31","author":"Fuschillo","year":"2008","journal-title":"Eur. Respir. J."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"340","DOI":"10.5578\/tt.2934","article-title":"Does airway colonization cause systemic inflammation in bronchiectasis?","volume":"59","year":"2011","journal-title":"Tuberk. Toraks"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1016\/S1579-2129(09)73450-0","article-title":"Inflammation markers in the exhaled air of patients with bronchiectasis unassociated with cystic fibrosis","volume":"45","author":"Cortijo","year":"2009","journal-title":"Arch. Bronconeumol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1183\/09031936.06.00074605","article-title":"The effect of Pseudomonas aeruginosa on pulmonary function in patients with bronchiectasis","volume":"28","author":"Davies","year":"2006","journal-title":"Eur. Respir. J."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/8\/3\/315\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T12:36:33Z","timestamp":1760186193000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/8\/3\/315"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,6]]},"references-count":31,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2019,3]]}},"alternative-id":["jcm8030315"],"URL":"https:\/\/doi.org\/10.3390\/jcm8030315","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2019,3,6]]}}}