Microbiological Factors and Patient-Reported Outcomes of Exacerbation Burden in Pseudomonas aeruginosa-Colonised Bronchiectasis: A One-Year Prospective Study

Background

Exacerbations are key determinants of disease progression and impaired health-related quality of life (HRQoL) in non-cystic fibrosis bronchiectasis (BE). Despite the recognised association between Pseudomonas aeruginosa (PA) and worse outcomes, factors driving exacerbation burden remain poorly characterised. In patients with PA-colonised BE, we aimed to assess whether microbiological factors, including colonisation status and PA phenotype, together with HRQoL domains and respiratory symptoms, were associated with time to first exacerbation, exacerbation severity, and post-exacerbation changes in HRQoL. Materials and Methods: This prospective longitudinal study followed PA-colonised BE adults for 12 months with quarterly stable-state assessments focussing on time and severity of first exacerbation. HRQoL was measured by the Quality of Life Questionnaire-Bronchiectasis (QOL-B). Multivariable Cox, Firth penalised logistic, and ANCOVA models were fitted in R.