Clinical characteristics of infants with protracted bacterial bronchitis: an observational cohort study.

Abstract

Background: Infants with protracted bacterial bronchitis (PBB) have been reported in case reports and limited small case series, which is not commonly recognized. The aim of the study is to determine the clinical features and image findings of infants with PBB for early detection and diagnosis.

Methods: Infants with PBB were prospectively enrolled during January 2021 to January 2024 in Guangzhou Women and Children's Medical Center. Clinical data were collected, including clinical manifestations, laboratory parameters, radiological findings, management, and follow-up.

Results: There were 37 patients included (30 boys, 81.08%; 7 girls, 18.92%) with a median onset age of 6 months [interquartile range (IQR), 4-7.5 months]. All patients presented with wet cough (100.00%), 34 presented with persistent wheezing (91.89%). Moraxella bacteria (12/37, 32.43%) and Streptococcus pneumoniae (11/37, 29.73%) were the most often diagnosed pathogens. There were nine patients detected with multiple drug-resistant strains by bronchoalveolar lavage (BAL) cultures (9/32, 28.13%). Uneven inflation was the most common form of chest computed tomography (CT) manifestation (27/37, 72.97%). Under bronchoscopy, thick pale yellow or yellow mucus was attached to the airway in all patients. The use of antibiotics was permitted for all infants with PBB after a definite diagnosis (37/37, 100.00%). The condition can be completely mitigated (34/37, 91.89%), only three patients developed recurrent PBB.

Conclusions: Wheezing was a very common clinical performance in infants with PBB, and the most common pathogens were Moraxella bacteria and Streptococcus pneumoniae. The CT performance of PBB mainly is uneven inflation in infants.