The contribution of infection to clinical outcomes in bronchiectasis: a prospective cohort study.

OBJECTIVES

The impact of on the prognosis of bronchiectasis remains controversial. This study aimed to explore the prognostic value of in adult patients with bronchiectasis in central-southern China.

PATIENTS AND METHODS

This prospective cohort study enrolled 1,234 patients with bronchiectasis between 2013 and 2019. The independent impact of on all-cause mortality, annual exacerbations, and hospitalizations was assessed.

RESULTS

was isolated from 244 patients (19.8%). A total of 188 patients died over a follow-up period of 16 (1-36) months. Patients with had a longer disease course, poorer lung function, more lung lobe involvement, and more severe Bronchiectasis Severity Index (BSI) stage than those without . The independent impact of was observed on frequent hospitalizations but not on mortality and frequent exacerbations. Moderate- or high-risk comorbidities increased the risk of mortality (hazard ratio [HR]: 1.93, 95% confidence interval [CI]: 1.26-2.95), and this effect was magnified by the presence of (HR: 2.11, 95% CI: 1.28-3.48).

CONCLUSIONS

infection acts as a marker of disease severity as well as predictor of frequent hospitalizations. had no independent effect on all-cause mortality. combined with moderate- or high-risk comorbidities posed an increased risk of mortality. The management of comorbidities may be a critical target during the treatment of infection in bronchiectasis.KEY MESSAGE: increased the risk of frequent hospitalizations; however, it had no independent impact on all-cause mortality. combined with moderate- or high-risk comorbidities posed an increased risk of mortality.The management of comorbidities may be a critical target during the treatment of infection in bronchiectasis.