Clinical, Radiological and Microbiological Profile of Bronchiectasis in Adults in a Tertiary Care Hospital: A Cross Sectional Study

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Varying etiological factors and clinical presentations geographically, necessitate region-specific studies. This study aims to assess the clinical, microbiological and radiological profile in patients with bronchiectasis at a tertiary care center. Methods A cross-sectional study was conducted at Department of Respiratory Medicine, of a tertiary care hospital from February 2023 till September 2025. A total of 136 patients diagnosed with bronchiectasis were enrolled. Clinical evaluation, high-resolution computed tomography (HRCT) of the thorax, and microbiological assessment, including sputum and bronchoalveolar lavage (BAL) cultures along with spirometry were performed. The antimicrobial susceptibility of isolated pathogens was analyzed. Statistical analysis was conducted using descriptive methods. Results Among 70 patients, 55.7% were female, and the majority (51.2%) was aged 61–70 years. The most common symptoms included cough (73.2%), sputum production (70.7%), and dyspnea (60.9%). HRCT findings revealed a predominance of cystic (46.3%) and cylindrical (39%) patterns, with 65.9% of cases showing bilateral lung involvement. Microbiological analysis identified Pseudomonas aeruginosa (44.3%) as the most frequently isolated pathogen, followed by Klebsiella pneumoniae (27.1%). Patients with Pseudomonas aeruginosa exhibited more severe radiological involvement, including multilobar and cystic patterns. Spirometry analysis of the study participants revealed mixed (obstruction + restriction) pattern of air flow limitation (60%) followed by restrictive pattern (22%), while obstructive pattern was observed in 18% patients. Conclusion This study highlights the significant burden of bronchiectasis in elderly patients, with post-tuberculosis sequelae being a predominant etiological factor. Pseudomonas aeruginosa colonization is associated with more extensive radiological involvement, underscoring the need for targeted antimicrobial strategies. Comprehensive management approaches should address both underlying etiologies and associated co-morbidities to improve patient outcomes Bronchiectasis Post-tuberculosis sequelae Spirometry Pseudomonas aeruginosa Introduction Bronchiectasis is a chronic respiratory disease characterized by permanent airway dilatation, associated with chronic cough, sputum production, and recurrent pulmonary exacerbations. In recent years, both the incidence and prevalence of bronchiectasis have increased globally, likely driven by improvements in imaging technology, greater disease awareness, and early detection, thereby adding to the socioeconomic burden and healthcare utilization [ 1 , 2 ]. In many bronchiectasis cohorts, 5-year mortality rates between ~ 16% and ~ 25% have been observed [ 1 , 3 ]. However, epidemiological estimates remain heterogeneous: population prevalence figures range from 50 to more than 1,000 per 100,000, depending on geographic region, diagnostic criteria, and study methodology [ 1 , 4 , 5 ]. Data from the Indian Bronchiectasis Registry (EMBARC-India) reveal that the clinical profile of Indian patients differs markedly from that in Western cohorts. Indian patients tend to be younger, more often male, and have more severe disease by both multidimensional scoring systems and radiological burden [ 6 , 7 ]. Etiological contributors and clinical features of bronchiectasis vary by geography. While many patients globally are categorized as “idiopathic,” recent data from the US underscore the role of immune dysregulation. By contrast, in India, post-infectious bronchiectasis (especially post-tuberculosis) predominates [ 8 , 9 ]. Other recognized causes include allergic bronchopulmonary aspergillosis (ABPA), primary and secondary immunodeficiencies, connective tissue diseases, cystic fibrosis, asthma, COPD, primary ciliary dyskinesia, and mixed or unknown etiologies [ 9 , 10 ]. Distinguishing underlying cause is critical, given differences in management and prognosis [ 5 ]. Given the marked phenotypic and etiologic differences between Indian and Western bronchiectasis, there is an urgent need for longitudinal data from Asian settings. It remains uncertain whether risk factors for exacerbations and mortality established in European cohorts apply in India, or whether prognostic tools such as the Bronchiectasis Severity Index (BSI), developed largely from European datasets, retain validity in the Indian context [ 6 , 7 , 11 ]. Bronchiectasis pathophysiology is closely tied to microbial colonization of the airways, with recurrent infection and chronic inflammation undermining mucociliary clearance and driving progressive lung injury [ 12 ]. Common pathogens include Haemophilus influenzae, Pseudomonas aeruginosa, Moraxella catarrhalis, Staphylococcus aureus, and members of the Enterobacteriaceae family [ 13 ]. Importantly, colonization by certain species (e.g. P. aeruginosa or Gram-negative bacilli) is linked to worse outcomes [ 13 , 14 ]. In India and other TB-endemic regions, the microbiological landscape is especially heterogeneous. Molecular diagnostics have revealed a wider spectrum of pathogens, and in Indian cohorts, up to one in ten patients harbour Enterobacteriaceae, which in turn is associated with increased mortality [ 6 , 14 , 15 ]. The predominance of tuberculosis as a cause of bronchiectasis poses a challenge in endemic region like India, where access to physiotherapy, microbiology services, inhaled antibiotics, and long-term follow-up may be constrained [ 16 ]. In this study we aimed to evaluate clinical, radiological and microbiological profile of bronchiectasis in patients visiting tertiary care hospital. Material & Methods Study Design and Setting : This cross-sectional study was conducted in patients diagnosed with bronchiectasis that visited the outpatient department (OPD) or are admitted the Department of Respiratory Medicine of tertiary care hospital from February 2023 till September 2025. Inclusion Criteria • Patients aged >18 years diagnosed with bronchiectasis. • Patients who have given informed consent to participate in the study. Exclusion Criteria • Patients unwilling to participate in the study. • Pregnant women. Ethics committee approval : A prior approval was obtained from the Institutional Ethics Committee (Reference Number: I.E.S.C./PGS/2023/65, Dated: 26/12/2023) Methodology in details Patients who attended the OPD and admitted in Respiratory Medicine Department after fulfilling the selection criteria and radiological features diagnostic of bronchiectasis or previously diagnosed cases of bronchiectasis were included in the study. After explaining the purpose of the study, written informed consent was obtained from the participants. Demographic data, childhood history, symptomatology and significant past and personal history were noted in case record proforma. X-ray and HRCT chest was done to assess the radiological involvement. Sputum acid-fast bacilli (AFB) smear and culture, Cartridge based nucleic acid amplification test (CBNAAT), sputum culture and sensitivity and gram staining was done to assess the microbiological colonization. Spirometry was done for airway assessment. Data Collection Clinical profile : Symptomology that is cough with or without expectoration, dyspnea (mMRC grading), hemoptysis, fever and clinical signs that is crepitation, clubbing, and rhonchi were assessed. Information regarding past and personal history were collected. Pulmonary function assessment : was done using spirometer and interpretation was done as follows- Obstructive Pattern : ↓FEV₁/FVC ratio (<0.70). FEV₁ ↓, FVC normal or ↓. Restrictive Pattern : FEV₁/FVC normal or ↑ (≥0.70) with ↓FVC (<80% predicted). Confirms restriction only if ↓TLC (<80%). Mixed Pattern : Both FEV₁/FVC ↓ and FVC ↓ (<80%), indicating coexisting obstruction and restriction. Radiological pattern : Chest radiograph finding of bronchiectasis like linear atelectasis, dilated and thickened airways (i.e., tram or parallel lines, ring shadows on cross section) and irregular peripheral opacities etc. were noted. Different HRCT chest patterns like cylindrical, varicose, saccular and cystic bronchiectasis were analyzed in the study group. Lobe involvement which is either upper or middle or lower lobe and either unilateral or bilateral involvement in the study group were analyzed. Microbiological profile : Early morning sputum sample and in patients who were unable to expectorate, bronchoalveolar lavage was collected with the help of flexible bronchoscopy and sent for AFB smear, CBNAAT and microscopy, mycobacterium and bacteriological culture. Statistical analysis All the data was collected as per case record proforma and entered into MS excel sheet. Frequency of symptoms, signs, radiological findings and microbiological findings were presented as mean, percentage and absolute values. Results Among the 136 patients studied, majority were aged above 60 years, with a female predominance. A past history of tuberculosis was the most common underlying cause, followed by COPD and pneumonia. Diabetes mellitus and hypertension were the leading comorbidities, while a smaller proportion had coronary artery disease or chronic kidney disease. Other patient characteristics are mentioned in Table-1 Table-1 Patient characteristics Patients Characteristics Number (n) % Age (years) 18–30 18 16.8 31–45 36 26 46–60 44 30.1 > 60 38 37 Gender Male 56 41.2 Female 80 58.8 Past History /concomitant illness Tuberculosis 49 36.1 COPD 25 18.38 Pneumonia 20 14.7 Childhood Fever 5 3.67 No definite etiology 37 27.2 Comorbidities Diabetes mellitus 31 31.7 Hypertension 30 22 Dyslipidemia 16 12.2 Coronary artery disease 22 24.4 Chronic kidney disease 3 4.9 No comorbidity 34 48.8 Table-2 Microbiological Profile of study participants Microorganism Number (n) % Pseudomonas aeruginosa 46 34 Klebsiella pneumoniae 30 22 Acinetobacter baumannii 16 12 No micro-organism growth 44 32 In our study, blood and bronchoalveolar lavage samples observed no growth of microorganisms The sputum culture results showed Pseudomonas aeruginosa as the most common isolate, followed by Klebsiella pneumoniae and Acinetobacter baumannii, indicating that gram-negative pathogens are the predominant colonizers in bronchiectasis patients. (Table-2) Table-3 Radiological Profile of study participants Parameter Category No. of Patients (%) X-ray Pattern Bilateral Involvement 90 66.2% Right-Side Involvement 26 19.1% Left-Side Involvement 20 14.7% Total 136 100 CT Pattern Cystic Pattern 65 47.8% Cylindrical Pattern 41 30.1% Mixed Pattern (Varicose and Cystic) 30 22.1% Total 136 100% Number of Lobes Involved Single Lobe Involvement 30 19.5% 2 Lobes Involved 47 39% 3 Lobes Involved 39 26.8% 5 Lobes Involved 20 14.6% Total 136 100% Chest radiographic evaluation revealed bilateral involvement in most patients. On HRCT, the cystic pattern was the most common, followed by cylindrical and mixed (varicose and cystic) types. Lower lobes were most frequently affected, though upper and middle lobe involvement were also common. The majority of patients showed multi-lobar disease, indicating extensive bronchiectatic changes. (Table − 3) Table-4 Correlation of Radiological Patterns with Microbiological findings Radiological Finding Pseudomonas aeruginosa (n = 46) Klebsiella pneumoniae (n = 30) A. Baumannii (n = 16) No Growth (n = 44) Total (n = 136) X-ray Pattern Bilateral Involvement 34 (73.9%) 20 (66.7%) 13 (81.3%) 23 (52.3%) 90 (66.2%) Right-Side Involvement 6 (17.4%) 4 (13.3%) 1 (6.3%) 15 (34.1%) 26 (19.1%) Left-Side Involvement 6 (10.9%) 6 (16.7%) 2 (12.5%) 6 (13.6%) 20 (14.1%) HRCT Pattern Cystic Pattern 30 (65.2%) 16 (53.3%) 9 (56.3%) 10 (22.7%) 65 (47.8%) Cylindrical Pattern 9 (19.6%) 9 (30%) 2 (12.5%) 21 (47.7%) 41 (30.1%) Mixed Pattern (Varicose/Cystic) 7 (15.2%) 5 (16.7%) 5 (31.3%) 13 (29.5%) 30 (22.1%) Lobe Involvement Lower Lobe Involvement 31 (65.2%) 23 (73.3%) 12 (75%) 19 (40.9%) 85 (62.5%) Upper Lobe Involvement 28 (60.9%) 17 (56.7%) 8 (50%) 28 (65.9%) 81 (59.6%) Middle Lobe Involvement 19 (43.5%) 12 (43.3%) 3 (18.8%) 28 (68.2%) 62 (49.3%) Single Lobe Involvement 8 (17.4%) 7 (23.3%) 1 (6.3%) 13 (29.5%) 30 (22.1%) 2 Lobes Involved 18 (39.1%) 11 (36.7%) 4 (25%) 14 (31.8%) 47 (34.6%) 3 Lobes Involved 15 (32.6%) 11 (36.7%) 8 (50%) 5 (11.4%) 39 (28.7%) 5 Lobes Involved 5 (10.9%) 1 (3.3%) 3 (18.8%) 12 (27.3%) 20 (14.7%) Pseudomonas aeruginosa was the predominant isolate, mainly associated with bilateral lung involvement, cystic bronchiectasis, and multilobar disease. Klebsiella pneumoniae and Acinetobacter baumannii also showed similar patterns with lower lobe predominance. In contrast, patients with no bacterial growth more often had unilateral, cylindrical, or limited lobe involvement, indicating that pathogenic colonization correlates with greater radiological severity. (Table – 4) Table-5 Spirometry Profile of the study participants Spirometry Pattern Number (n) % Mixed 82 60.3% Obstruction 24 17.7% Restriction 30 22% Total 136 100% In the present study, spirometry revealed that the majority of patients exhibited a mixed ventilatory pattern, followed by restrictive and obstructive patterns. This indicates that most bronchiectasis patients had combined airway obstruction and reduced lung volumes, reflecting extensive and chronic airway damage. (Table – 5) Discussion Bronchiectasis is a chronic respiratory illness which can lead to chronic debilitating conditions like allergic bronchopulmonary aspergillosis, immunodeficiency syndromes, connective tissue diseases (CTD), cystic fibrosis (CF) and primary ciliary dyskinesia (PCD) [ 17 , 18 ]. Since these conditions differ in their management and prognosis, diagnosis of underlying etiology is important. Since sparse data is available from developing countries especially from Southeast Asia, we found it imperative to collect the data from this part of the world. The aim of the study was to identify the underlying etiology of bronchiectasis, to assess the clinical presentation, radiological findings, and microbiological profile of patients who presented with a diagnosis of bronchiectasis in our tertiary care centre. In the present study, the majority of patients were aged above 60 years (37%), followed by those between 46–60 years (30%). A female predominance (76.5%) was observed, and 36.1% of patients had a past history of tuberculosis. Diabetes mellitus was the most frequent co-morbidity (31.7%). Singh A et al. [ 19 ] similarly reported that most bronchiectasis patients were aged 61–70 years (51.2%), with a prior history of tuberculosis in 34.1% and diabetes mellitus in 31.7%. The predominant symptoms were cough (73.2%), expectoration (70.7%), and dyspnea (60.9%), with crepitations (73.1%) and clubbing (61%) being common findings. Bajpai J et al. [ 20 ] observed that post-tuberculosis bronchiectasis patients (Group 1) were younger (36.08 ± 13.08 years) than those with non-tuberculous etiologies (46.5 ± 14.17 years, p = 0.005), with male predominance (54.55%) and higher prevalence of cough and smoking. Dhaker DC et al. [ 21 ] reported male predominance (77.61%), middle age group (45–60 years, 37.31%), and undernutrition (BMI < 18.5 kg/m² in 73.13%). COPD (47.36%) and diabetes mellitus (21.05%) were the most frequent comorbidities. These observations collectively suggest that bronchiectasis in the present cohort primarily affected elderly females with prior tuberculosis, whereas other Indian studies demonstrated male predominance and smoking-related disease. Spirometric analysis in this study revealed a mixed (restrictive + obstructive) pattern in most patients (60.29%), followed by restrictive (22.05%) and obstructive (17.64%) patterns. Stephen Sunny and Mathew Ninan [ 22 ] observed obstruction in 60.97% and restriction in 14.6% of patients, while Naveen et al. [ 23 ] reported obstructive (52%) and normal (37%) patterns. Niranjan Prabhakar et al. [ 24 ] also identified obstruction as the commonest abnormality (43.3%). Similarly, Sharif N et al. [ 25 ] reported obstructive impairment in 68.9% and nonspecific impairment in 20.4%. In Dhaker DC et al. [ 21 ], obstructive, restrictive, and mixed patterns were seen in 41.86%, 37.21%, and 20.93%, respectively. Bajpai J et al. [ 20 ] reported no significant difference in FEV₁ and FVC between post-tuberculosis and non-tuberculous groups; however, FEV₁/FVC ratios were significantly lower in post-tubercular bronchiectasis (p < 0.01), indicating greater airflow limitation. Collectively, these findings demonstrate that bronchiectasis is characterized by predominant airway obstruction with variable restrictive components, reflecting chronic airway remodelling and fibrosis. Microbiological analysis in the present study identified Pseudomonas aeruginosa as the most frequent isolate (33.82%), followed by Klebsiella pneumoniae (22.05%) and Acinetobacter baumannii (11.76%). Similar trends were reported by Aravind Guru Prakash et al. [ 26 ], who found Pseudomonas (18%) and Klebsiella (9%) as the most common pathogens. Stephen Sunny and Mathew Ninan [ 22 ] observed Pseudomonas (43.9%) and Klebsiella (26.8%) predominance, while Naveen et al. [ 23 ] reported Pseudomonas (37.5%), Klebsiella (30%), and Streptococcus pneumoniae (15%). Niranjan Prabhakar et al. [ 24 ] also found Pseudomonas in 21.25% of cases, with a significant association with cystic bronchiectasis. Sharif N et al. [ 25 ] reported Pseudomonas (36.2%), Moraxella catarrhalis (11.2%), and Haemophilus influenzae (8.2%) as major isolates. Singh A et al. [ 19 ] observed Pseudomonas associated with bilateral (71%) and cystic (58%) involvement, while Klebsiella was linked to lower lobe and cystic disease (47%). Dhaker DC et al.[ 21 ] reported Mycobacteria (38.09%) as the most frequent, followed by Pseudomonas (17.46%) and Klebsiella (11.11%). Bajpai J et al. [ 20 ] also reported Pseudomonas as the predominant pathogen across both post-tubercular and non-tubercular groups. Overall, Pseudomonas aeruginosa remains the most consistently isolated organism across studies and is often associated with more severe, bilateral, cystic disease patterns and poorer prognosis [ 27 – 29 ]. Radiological evaluation in this study revealed bilateral involvement in 65.9% of cases on chest radiography. HRCT findings demonstrated cystic bronchiectasis in 47.79%, cylindrical in 30.14%, and mixed (varicose and cystic) patterns in 22.05%. The lower lobes were most frequently involved (63.4%), followed by the upper (61%) and middle lobes (48.8%). Similar observations were reported by Aravind Guru Prakash et al. [ 26 ], who found tractional bronchiectasis (59%) as the predominant HRCT pattern, mainly involving bilateral upper lobes (35%). Stephen Sunny and Mathew Ninan [ 22 ] observed cystic (46.3%), cylindrical (39%), and mixed (14.6%) patterns, with predominant lower lobe involvement (63.4%). Niranjan Prabhakar et al. [ 24 ] reported bilateral lower lobe disease in 23.62% and right-sided lesions in 48.81%. Sharif N et al. [ 25 ] found upper lobe predominance (41.8%) with diffuse bilateral disease (20.4%). Singh A et al. [ 19 ] reported similar trends with cystic (46.3%) and bilateral (65.9%) patterns. Dhaker DC et al. [ 21 ] observed mixed (46.27%), tractional (25.37%), and cystic (13.43%) patterns, with right upper lobe predominance (37.31%). Bajpai J et al. [ 20 ] found cystic bronchiectasis more common in non-tubercular cases (86.36% vs. 66.67%, p = 0.014), while fibro-cavitary and “tram-track” changes were more frequent post-tuberculosis (p < 0.05). These results collectively indicate that cystic and mixed bronchiectatic patterns with bilateral, multilobar distribution are the dominant radiological features, particularly in post-tuberculosis cases [ 30 – 33 ]. In the present study of 136 patients, most were aged above 60 years, with a female predominance. A past history of tuberculosis was seen in 36.1%, and diabetes mellitus was the most common co-morbidity. The most common radiological pattern was cystic bronchiectasis, and Pseudomonas aeruginosa was the predominant coloniser. This study highlights the clinical, radiological, and microbiological profile for better management of bronchiectasis. Limitations • Being a single center study, the findings of study could not be generalized • Limited Sample size, thus studies with larger sample size are recommended to further strengthen our findings. • Lack of comparative group which could have further broadened the knowledge on bronchiectasis. Conclusion Bronchiectasis in this study predominantly affected elderly females, with post-tuberculosis sequelae as the leading etiology. Cough, sputum production, and dyspnea were the most common symptoms, while spirometry revealed a mixed ventilatory defect in the majority. HRCT demonstrated mainly cystic and bilateral lower lobe involvement, reflecting advanced structural lung damage. Pseudomonas aeruginosa was the most frequent isolate, associated with severe and cystic disease patterns. Overall, post-tuberculosis bronchiectasis with Pseudomonas colonization and mixed functional impairment defines the characteristic profile in this setting. Early identification and targeted antimicrobial management are essential to limit disease progression and improve outcomes. Abbreviations ABPA – Allergic Bronchopulmonary Aspergillosis AFB – Acid-Fast Bacilli BAL – Bronchoalveolar Lavage BMI – Body Mass Index BSI – Bronchiectasis Severity Index CBNAAT – Cartridge-Based Nucleic Acid Amplification Test CF – Cystic Fibrosis CKD – Chronic Kidney Disease COPD – Chronic Obstructive Pulmonary Disease CT – Computed Tomography CTD – Connective Tissue Disease DM – Diabetes Mellitus EMBARC – European Multicentre Bronchiectasis Audit and Research Collaboration FEV₁ – Forced Expiratory Volume in One Second FVC – Forced Vital Capacity HRCT – High-Resolution Computed Tomography IESC – Institutional Ethics Subcommittee / Committee mMRC – Modified Medical Research Council (Dyspnea Scale) MS – Microsoft OPD – Outpatient Department PCD – Primary Ciliary Dyskinesia TB – Tuberculosis TLC – Total Lung Capacity US – United States CAD – Coronary Artery Disease HRCT –High Resolution Computed Tomography HTN – Hypertension DM – Diabetes Mellitus P. aeruginosa – Pseudomonas aeruginosa K. pneumoniae – Klebsiella pneumoniae A. baumannii – Acinetobacter baumannii CFU – Colony Forming Unit (implied in microbiology context) Declarations Acknowledgements : Not applicable. Authors’ contributions : PD wrote the initial draft of the manuscript. SSD and PD managed the diagnosis and treatment. SSD wrote the original draft. SSD and PD reviewed and edited the draft. SSD and PD approved the final version of the manuscript and agreed to be accountable for all aspects of the work. All authors read and approved the final manuscript. Funding: The study received no external funding. Data availability : The datasets used and/or analyzed during the current study will be available from the corresponding author on reasonable request. Ethics approval : The institutional review board approved the study. (Reference Number: I.E.S.C./PGS/2023/65, Dated: 26/12/2023) Consent for publication : All individuals included in the study signed the informed consent for participation and publication. Competing interests : Nil References Nigro M, Laska IF, Traversi L, et al. Epidemiology of bronchiectasis: a narrative review with updated data. Eur Respir Rev. 2024;33(174):240091. 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Phenotypic heterogeneity and radiological patterns in bronchiectasis. Eur Respir Rev. 2023;32(169):230005. Choi H, et al. Regional variation in bronchiectasis imaging patterns: comparison of Asian and European cohorts. Respir Res. 2023;24(1):45. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7883591","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":545744035,"identity":"097263a4-2bfa-46b0-928f-5b6638d64219","order_by":0,"name":"Dr.Sachinkumar Dole","email":"","orcid":"","institution":"Dr. D.Y. 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Patil Medical College, Hospital \u0026 Research Centre","correspondingAuthor":true,"prefix":"Dr.","firstName":"Pratiksha","middleName":"","lastName":"Dutta","suffix":""}],"badges":[],"createdAt":"2025-10-17 07:08:23","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7883591/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7883591/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":96602819,"identity":"e0dd9c01-d024-4bab-ae23-3e8708c4c112","added_by":"auto","created_at":"2025-11-24 09:02:22","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":50611,"visible":true,"origin":"","legend":"","description":"","filename":"MANUSCRIPT.docx","url":"https://assets-eu.researchsquare.com/files/rs-7883591/v1/356c8011b8cbfec7d17737d4.docx"},{"id":96465817,"identity":"015875dd-a7bf-419a-8244-9b63d85dc67f","added_by":"auto","created_at":"2025-11-21 11:19:22","extension":"json","order_by":1,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":5235,"visible":true,"origin":"","legend":"","description":"","filename":"828bbbf254b14613a90d51b8a147d6c4.json","url":"https://assets-eu.researchsquare.com/files/rs-7883591/v1/c0b7adb7c8a562dae272be22.json"},{"id":96603615,"identity":"db4f3c55-6b4f-4d4c-b3ef-3dfe93dc95bb","added_by":"auto","created_at":"2025-11-24 09:10:39","extension":"xml","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":89995,"visible":true,"origin":"","legend":"","description":"","filename":"828bbbf254b14613a90d51b8a147d6c41enriched.xml","url":"https://assets-eu.researchsquare.com/files/rs-7883591/v1/8fe48d9800cabd32eca1dddf.xml"},{"id":96465814,"identity":"4a185faf-f538-4e95-b7d6-19c2eb1b9243","added_by":"auto","created_at":"2025-11-21 11:19:22","extension":"jpeg","order_by":3,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":39017,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7883591/v1/688a35a49cd938c4420bbc3b.jpeg"},{"id":96603334,"identity":"c2d994ef-1b52-4f53-b038-ed5ef63a4d7e","added_by":"auto","created_at":"2025-11-24 09:08:19","extension":"png","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":8584,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7883591/v1/c321a8ac810d24c33756dc34.png"},{"id":96465818,"identity":"7560ac90-08a8-4c1b-9780-82cc55ca6fa7","added_by":"auto","created_at":"2025-11-21 11:19:22","extension":"xml","order_by":5,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":89965,"visible":true,"origin":"","legend":"","description":"","filename":"828bbbf254b14613a90d51b8a147d6c41structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-7883591/v1/5993ac03f343f02fdc6610a6.xml"},{"id":96465820,"identity":"ba97976d-22e8-4704-a473-f70e29e7fcf5","added_by":"auto","created_at":"2025-11-21 11:19:22","extension":"html","order_by":6,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":98141,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7883591/v1/18ef168c8dc1a68d79c1fb16.html"},{"id":97945598,"identity":"4f0853ac-b1a4-4464-9163-95dd18cd56d5","added_by":"auto","created_at":"2025-12-11 05:39:02","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":948521,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7883591/v1/5bce4381-d773-4ad0-af18-c2396a6cfc7b.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eClinical, Radiological and Microbiological Profile of Bronchiectasis in Adults in a Tertiary Care Hospital: A Cross Sectional Study\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eBronchiectasis is a chronic respiratory disease characterized by permanent airway dilatation, associated with chronic cough, sputum production, and recurrent pulmonary exacerbations. In recent years, both the incidence and prevalence of bronchiectasis have increased globally, likely driven by improvements in imaging technology, greater disease awareness, and early detection, thereby adding to the socioeconomic burden and healthcare utilization [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. In many bronchiectasis cohorts, 5-year mortality rates between ~\u0026thinsp;16% and ~\u0026thinsp;25% have been observed [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. However, epidemiological estimates remain heterogeneous: population prevalence figures range from 50 to more than 1,000 per 100,000, depending on geographic region, diagnostic criteria, and study methodology [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Data from the Indian Bronchiectasis Registry (EMBARC-India) reveal that the clinical profile of Indian patients differs markedly from that in Western cohorts. Indian patients tend to be younger, more often male, and have more severe disease by both multidimensional scoring systems and radiological burden [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Etiological contributors and clinical features of bronchiectasis vary by geography. While many patients globally are categorized as \u0026ldquo;idiopathic,\u0026rdquo; recent data from the US underscore the role of immune dysregulation. By contrast, in India, post-infectious bronchiectasis (especially post-tuberculosis) predominates [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Other recognized causes include allergic bronchopulmonary aspergillosis (ABPA), primary and secondary immunodeficiencies, connective tissue diseases, cystic fibrosis, asthma, COPD, primary ciliary dyskinesia, and mixed or unknown etiologies [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Distinguishing underlying cause is critical, given differences in management and prognosis [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Given the marked phenotypic and etiologic differences between Indian and Western bronchiectasis, there is an urgent need for longitudinal data from Asian settings. It remains uncertain whether risk factors for exacerbations and mortality established in European cohorts apply in India, or whether prognostic tools such as the Bronchiectasis Severity Index (BSI), developed largely from European datasets, retain validity in the Indian context [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Bronchiectasis pathophysiology is closely tied to microbial colonization of the airways, with recurrent infection and chronic inflammation undermining mucociliary clearance and driving progressive lung injury [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Common pathogens include Haemophilus influenzae, Pseudomonas aeruginosa, Moraxella catarrhalis, Staphylococcus aureus, and members of the Enterobacteriaceae family [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Importantly, colonization by certain species (e.g. P. aeruginosa or Gram-negative bacilli) is linked to worse outcomes [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. In India and other TB-endemic regions, the microbiological landscape is especially heterogeneous. Molecular diagnostics have revealed a wider spectrum of pathogens, and in Indian cohorts, up to one in ten patients harbour Enterobacteriaceae, which in turn is associated with increased mortality [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. The predominance of tuberculosis as a cause of bronchiectasis poses a challenge in endemic region like India, where access to physiotherapy, microbiology services, inhaled antibiotics, and long-term follow-up may be constrained [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIn this study we aimed to evaluate clinical, radiological and microbiological profile of bronchiectasis in patients visiting tertiary care hospital.\u003c/p\u003e"},{"header":"Material \u0026 Methods","content":"\u003cp\u003e\u003cstrong\u003eStudy Design and Setting\u003c/strong\u003e: This cross-sectional study was conducted in patients diagnosed with bronchiectasis that visited the outpatient department (OPD) or are admitted the Department of Respiratory Medicine of tertiary care hospital from February 2023 till September 2025.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInclusion Criteria\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026bull; \u0026nbsp; \u0026nbsp;Patients aged \u0026gt;18 years diagnosed with bronchiectasis.\u003c/p\u003e\n\u003cp\u003e\u0026bull; \u0026nbsp; \u0026nbsp;Patients who have given informed consent to participate in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eExclusion Criteria\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026bull; \u0026nbsp; \u0026nbsp;Patients unwilling to participate in the study.\u003c/p\u003e\n\u003cp\u003e\u0026bull; \u0026nbsp; \u0026nbsp;Pregnant women.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics committee approval\u003c/strong\u003e: A prior approval was obtained from the Institutional Ethics\u003c/p\u003e\n\u003cp\u003eCommittee (Reference Number: I.E.S.C./PGS/2023/65, Dated: 26/12/2023)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethodology in details\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePatients who attended the OPD and admitted in Respiratory Medicine Department after fulfilling the selection criteria and radiological features diagnostic of bronchiectasis or previously diagnosed cases of bronchiectasis were included in the study. After explaining the purpose of the study, written informed consent was obtained from the participants. Demographic data, childhood history, symptomatology and significant past and personal history were noted in case record proforma. X-ray and HRCT chest was done to assess the radiological involvement. Sputum acid-fast bacilli (AFB) smear and culture, Cartridge based nucleic acid amplification test (CBNAAT), sputum culture and sensitivity and gram staining was done to assess the microbiological colonization. Spirometry was done for airway assessment.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Collection\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical profile\u003c/strong\u003e: Symptomology that is cough with or without expectoration, dyspnea (mMRC grading), hemoptysis, fever and clinical signs that is crepitation, clubbing, and rhonchi were assessed. Information regarding past and personal history were collected.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePulmonary function assessment\u003c/strong\u003e: was done using spirometer and interpretation was done as follows-\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eObstructive Pattern\u003c/u\u003e: \u0026darr;FEV₁/FVC ratio (\u0026lt;0.70). FEV₁ \u0026darr;, FVC normal or \u0026darr;.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eRestrictive Pattern\u003c/u\u003e: FEV₁/FVC normal or \u0026uarr; (\u0026ge;0.70) with \u0026darr;FVC (\u0026lt;80% predicted). Confirms\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; restriction only if \u0026darr;TLC (\u0026lt;80%).\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eMixed Pattern\u003c/u\u003e: \u0026nbsp;Both FEV₁/FVC \u0026darr; and FVC \u0026darr; (\u0026lt;80%), indicating coexisting obstruction and\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; restriction.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRadiological pattern\u003c/strong\u003e: Chest radiograph finding of bronchiectasis like linear atelectasis, dilated and thickened airways (i.e., tram or parallel lines, ring shadows on cross section) and irregular peripheral opacities etc. were noted. Different HRCT chest patterns like cylindrical, varicose, saccular and cystic bronchiectasis were analyzed in the study group. Lobe involvement which is either upper or middle or lower lobe and either unilateral or bilateral involvement in the study group were analyzed.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMicrobiological profile\u003c/strong\u003e: Early morning sputum sample and in patients who were unable to expectorate, bronchoalveolar lavage was collected with the help of flexible bronchoscopy and sent for AFB smear, CBNAAT and microscopy, mycobacterium and bacteriological culture.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll the data was collected as per case record proforma and entered into MS excel sheet. Frequency of symptoms, signs, radiological findings and microbiological findings were presented as mean, percentage and absolute values.\u0026nbsp;\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eAmong the 136 patients studied, majority were aged above 60 years, with a female predominance. A past history of tuberculosis was the most common underlying cause, followed by COPD and pneumonia. Diabetes mellitus and hypertension were the leading comorbidities, while a smaller proportion had coronary artery disease or chronic kidney disease. Other patient characteristics are mentioned in Table-1\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eTable-1\u003c/strong\u003e\u003cp\u003ePatient characteristics\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabb\" border=\"1\"\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePatients Characteristics\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNumber (n)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003eAge (years)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e18\u0026ndash;30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e31\u0026ndash;45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e26\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e46\u0026ndash;60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e30.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e37\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e41.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e58.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePast History /concomitant illness\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTuberculosis\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e36.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCOPD\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18.38\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePneumonia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eChildhood Fever\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.67\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo definite etiology\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e27.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eComorbidities\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDiabetes mellitus\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e31.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypertension\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDyslipidemia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCoronary artery disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e24.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eChronic kidney disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo comorbidity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e48.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eTable-2\u003c/strong\u003e\u003cp\u003eMicrobiological Profile of study participants\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabc\" border=\"1\"\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMicroorganism\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNumber (n)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePseudomonas aeruginosa\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e34\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eKlebsiella pneumoniae\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAcinetobacter baumannii\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo micro-organism growth\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e32\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eIn our study, blood and bronchoalveolar lavage samples observed no growth of microorganisms The sputum culture results showed Pseudomonas aeruginosa as the most common isolate, followed by Klebsiella pneumoniae and Acinetobacter baumannii, indicating that gram-negative pathogens are the predominant colonizers in bronchiectasis patients. (Table-2)\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eTable-3\u003c/strong\u003e\u003cp\u003eRadiological Profile of study participants\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabd\" border=\"1\"\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eParameter\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCategory\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNo. of Patients\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e(%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eX-ray Pattern\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBilateral Involvement\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e66.2%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRight-Side Involvement\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e19.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLeft-Side Involvement\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e14.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e136\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e100\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eCT Pattern\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCystic Pattern\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e47.8%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCylindrical Pattern\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e30.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMixed Pattern (Varicose and Cystic)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e22.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e136\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e100%\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eNumber of Lobes Involved\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSingle Lobe Involvement\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e19.5%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2 Lobes Involved\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e39%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3 Lobes Involved\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e26.8%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5 Lobes Involved\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e14.6%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e136\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e100%\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eChest radiographic evaluation revealed bilateral involvement in most patients. On HRCT, the cystic pattern was the most common, followed by cylindrical and mixed (varicose and cystic) types. Lower lobes were most frequently affected, though upper and middle lobe involvement were also common. The majority of patients showed multi-lobar disease, indicating extensive bronchiectatic changes. (Table \u0026minus;\u0026thinsp;3)\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eTable-4\u003c/strong\u003e\u003cp\u003eCorrelation of Radiological Patterns with Microbiological findings\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabe\" border=\"1\"\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRadiological Finding\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePseudomonas aeruginosa\u003c/p\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;46)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eKlebsiella pneumoniae\u003c/p\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;30)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eA. Baumannii\u003c/p\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;16)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eNo Growth (n\u0026thinsp;=\u0026thinsp;44)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eTotal (n\u0026thinsp;=\u0026thinsp;136)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e\u003cp\u003eX-ray Pattern\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBilateral Involvement\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e34\u003c/p\u003e\u003cp\u003e(73.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e20\u003c/p\u003e\u003cp\u003e(66.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e13\u003c/p\u003e\u003cp\u003e(81.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e23\u003c/p\u003e\u003cp\u003e(52.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e90\u003c/p\u003e\u003cp\u003e(66.2%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRight-Side Involvement\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6\u003c/p\u003e\u003cp\u003e(17.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4\u003c/p\u003e\u003cp\u003e(13.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1\u003c/p\u003e\u003cp\u003e(6.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e15\u003c/p\u003e\u003cp\u003e(34.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e26\u003c/p\u003e\u003cp\u003e(19.1%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLeft-Side Involvement\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6\u003c/p\u003e\u003cp\u003e(10.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6\u003c/p\u003e\u003cp\u003e(16.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2\u003c/p\u003e\u003cp\u003e(12.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e6\u003c/p\u003e\u003cp\u003e(13.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e20\u003c/p\u003e\u003cp\u003e(14.1%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eHRCT Pattern\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCystic Pattern\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e30\u003c/p\u003e\u003cp\u003e(65.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16\u003c/p\u003e\u003cp\u003e(53.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e9\u003c/p\u003e\u003cp\u003e(56.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e10\u003c/p\u003e\u003cp\u003e(22.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e65\u003c/p\u003e\u003cp\u003e(47.8%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCylindrical Pattern\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e9\u003c/p\u003e\u003cp\u003e(19.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e9\u003c/p\u003e\u003cp\u003e(30%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2\u003c/p\u003e\u003cp\u003e(12.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e21\u003c/p\u003e\u003cp\u003e(47.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e41\u003c/p\u003e\u003cp\u003e(30.1%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMixed Pattern (Varicose/Cystic)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e7\u003c/p\u003e\u003cp\u003e(15.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5\u003c/p\u003e\u003cp\u003e(16.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5\u003c/p\u003e\u003cp\u003e(31.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e13\u003c/p\u003e\u003cp\u003e(29.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e30\u003c/p\u003e\u003cp\u003e(22.1%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eLobe Involvement\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLower Lobe Involvement\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e31\u003c/p\u003e\u003cp\u003e(65.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e23\u003c/p\u003e\u003cp\u003e(73.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e12\u003c/p\u003e\u003cp\u003e(75%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e19\u003c/p\u003e\u003cp\u003e(40.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e85\u003c/p\u003e\u003cp\u003e(62.5%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUpper Lobe Involvement\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e28\u003c/p\u003e\u003cp\u003e(60.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e17\u003c/p\u003e\u003cp\u003e(56.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8\u003c/p\u003e\u003cp\u003e(50%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e28\u003c/p\u003e\u003cp\u003e(65.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e81\u003c/p\u003e\u003cp\u003e(59.6%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMiddle Lobe Involvement\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e19\u003c/p\u003e\u003cp\u003e(43.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12\u003c/p\u003e\u003cp\u003e(43.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3\u003c/p\u003e\u003cp\u003e(18.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e28\u003c/p\u003e\u003cp\u003e(68.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e62\u003c/p\u003e\u003cp\u003e(49.3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSingle Lobe Involvement\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8\u003c/p\u003e\u003cp\u003e(17.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7\u003c/p\u003e\u003cp\u003e(23.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1\u003c/p\u003e\u003cp\u003e(6.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e13\u003c/p\u003e\u003cp\u003e(29.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e30\u003c/p\u003e\u003cp\u003e(22.1%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2 Lobes Involved\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e18\u003c/p\u003e\u003cp\u003e(39.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11\u003c/p\u003e\u003cp\u003e(36.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4\u003c/p\u003e\u003cp\u003e(25%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e14\u003c/p\u003e\u003cp\u003e(31.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e47\u003c/p\u003e\u003cp\u003e(34.6%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3 Lobes Involved\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e15\u003c/p\u003e\u003cp\u003e(32.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11\u003c/p\u003e\u003cp\u003e(36.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8\u003c/p\u003e\u003cp\u003e(50%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e5\u003c/p\u003e\u003cp\u003e(11.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e39\u003c/p\u003e\u003cp\u003e(28.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5 Lobes Involved\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5\u003c/p\u003e\u003cp\u003e(10.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003cp\u003e(3.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3\u003c/p\u003e\u003cp\u003e(18.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e12\u003c/p\u003e\u003cp\u003e(27.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e20\u003c/p\u003e\u003cp\u003e(14.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003ePseudomonas aeruginosa was the predominant isolate, mainly associated with bilateral lung involvement, cystic bronchiectasis, and multilobar disease. Klebsiella pneumoniae and Acinetobacter baumannii also showed similar patterns with lower lobe predominance. In contrast, patients with no bacterial growth more often had unilateral, cylindrical, or limited lobe involvement, indicating that pathogenic colonization correlates with greater radiological severity. (Table \u0026ndash; 4)\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eTable-5\u003c/strong\u003e\u003cp\u003eSpirometry Profile of the study participants\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabf\" border=\"1\"\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSpirometry Pattern\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNumber (n)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMixed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e82\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e60.3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eObstruction\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e17.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRestriction\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e22%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e136\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e100%\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eIn the present study, spirometry revealed that the majority of patients exhibited a mixed ventilatory pattern, followed by restrictive and obstructive patterns. This indicates that most bronchiectasis patients had combined airway obstruction and reduced lung volumes, reflecting extensive and chronic airway damage. (Table \u0026ndash; 5)\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eBronchiectasis is a chronic respiratory illness which can lead to chronic debilitating conditions like allergic bronchopulmonary aspergillosis, immunodeficiency syndromes, connective tissue diseases (CTD), cystic fibrosis (CF) and primary ciliary dyskinesia (PCD) [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Since these conditions differ in their management and prognosis, diagnosis of underlying etiology is important. Since sparse data is available from developing countries especially from Southeast Asia, we found it imperative to collect the data from this part of the world. The aim of the study was to identify the underlying etiology of bronchiectasis, to assess the clinical presentation, radiological findings, and microbiological profile of patients who presented with a diagnosis of bronchiectasis in our tertiary care centre. In the present study, the majority of patients were aged above 60 years (37%), followed by those between 46\u0026ndash;60 years (30%). A female predominance (76.5%) was observed, and 36.1% of patients had a past history of tuberculosis. Diabetes mellitus was the most frequent co-morbidity (31.7%). Singh A et al. [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e] similarly reported that most bronchiectasis patients were aged 61\u0026ndash;70 years (51.2%), with a prior history of tuberculosis in 34.1% and diabetes mellitus in 31.7%. The predominant symptoms were cough (73.2%), expectoration (70.7%), and dyspnea (60.9%), with crepitations (73.1%) and clubbing (61%) being common findings. Bajpai J et al. [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e] observed that post-tuberculosis bronchiectasis patients (Group 1) were younger (36.08\u0026thinsp;\u0026plusmn;\u0026thinsp;13.08 years) than those with non-tuberculous etiologies (46.5\u0026thinsp;\u0026plusmn;\u0026thinsp;14.17 years, p\u0026thinsp;=\u0026thinsp;0.005), with male predominance (54.55%) and higher prevalence of cough and smoking. Dhaker DC et al. [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e] reported male predominance (77.61%), middle age group (45\u0026ndash;60 years, 37.31%), and undernutrition (BMI\u0026thinsp;\u0026lt;\u0026thinsp;18.5 kg/m\u0026sup2; in 73.13%). COPD (47.36%) and diabetes mellitus (21.05%) were the most frequent comorbidities. These observations collectively suggest that bronchiectasis in the present cohort primarily affected elderly females with prior tuberculosis, whereas other Indian studies demonstrated male predominance and smoking-related disease.\u003c/p\u003e\u003cp\u003eSpirometric analysis in this study revealed a mixed (restrictive\u0026thinsp;+\u0026thinsp;obstructive) pattern in most patients (60.29%), followed by restrictive (22.05%) and obstructive (17.64%) patterns. Stephen Sunny and Mathew Ninan [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e] observed obstruction in 60.97% and restriction in 14.6% of patients, while Naveen et al. [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e] reported obstructive (52%) and normal (37%) patterns. Niranjan Prabhakar et al. [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e] also identified obstruction as the commonest abnormality (43.3%). Similarly, Sharif N et al. [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e] reported obstructive impairment in 68.9% and nonspecific impairment in 20.4%. In Dhaker DC et al. [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e], obstructive, restrictive, and mixed patterns were seen in 41.86%, 37.21%, and 20.93%, respectively. Bajpai J et al. [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e] reported no significant difference in FEV₁ and FVC between post-tuberculosis and non-tuberculous groups; however, FEV₁/FVC ratios were significantly lower in post-tubercular bronchiectasis (p\u0026thinsp;\u0026lt;\u0026thinsp;0.01), indicating greater airflow limitation. Collectively, these findings demonstrate that bronchiectasis is characterized by predominant airway obstruction with variable restrictive components, reflecting chronic airway remodelling and fibrosis.\u003c/p\u003e\u003cp\u003eMicrobiological analysis in the present study identified Pseudomonas aeruginosa as the most frequent isolate (33.82%), followed by Klebsiella pneumoniae (22.05%) and Acinetobacter baumannii (11.76%). Similar trends were reported by Aravind Guru Prakash et al. [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e], who found Pseudomonas (18%) and Klebsiella (9%) as the most common pathogens. Stephen Sunny and Mathew Ninan [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e] observed Pseudomonas (43.9%) and Klebsiella (26.8%) predominance, while Naveen et al. [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e] reported Pseudomonas (37.5%), Klebsiella (30%), and Streptococcus pneumoniae (15%). Niranjan Prabhakar et al. [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e] also found Pseudomonas in 21.25% of cases, with a significant association with cystic bronchiectasis. Sharif N et al. [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e] reported Pseudomonas (36.2%), Moraxella catarrhalis (11.2%), and Haemophilus influenzae (8.2%) as major isolates. Singh A et al. [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e] observed Pseudomonas associated with bilateral (71%) and cystic (58%) involvement, while Klebsiella was linked to lower lobe and cystic disease (47%). Dhaker DC et al.[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e] reported Mycobacteria (38.09%) as the most frequent, followed by Pseudomonas (17.46%) and Klebsiella (11.11%). Bajpai J et al. [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e] also reported Pseudomonas as the predominant pathogen across both post-tubercular and non-tubercular groups. Overall, Pseudomonas aeruginosa remains the most consistently isolated organism across studies and is often associated with more severe, bilateral, cystic disease patterns and poorer prognosis [\u003cspan additionalcitationids=\"CR28\" citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eRadiological evaluation in this study revealed bilateral involvement in 65.9% of cases on chest radiography. HRCT findings demonstrated cystic bronchiectasis in 47.79%, cylindrical in 30.14%, and mixed (varicose and cystic) patterns in 22.05%. The lower lobes were most frequently involved (63.4%), followed by the upper (61%) and middle lobes (48.8%). Similar observations were reported by Aravind Guru Prakash et al. [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e], who found tractional bronchiectasis (59%) as the predominant HRCT pattern, mainly involving bilateral upper lobes (35%). Stephen Sunny and Mathew Ninan [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e] observed cystic (46.3%), cylindrical (39%), and mixed (14.6%) patterns, with predominant lower lobe involvement (63.4%). Niranjan Prabhakar et al. [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e] reported bilateral lower lobe disease in 23.62% and right-sided lesions in 48.81%. Sharif N et al. [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e] found upper lobe predominance (41.8%) with diffuse bilateral disease (20.4%). Singh A et al. [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e] reported similar trends with cystic (46.3%) and bilateral (65.9%) patterns. Dhaker DC et al. [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e] observed mixed (46.27%), tractional (25.37%), and cystic (13.43%) patterns, with right upper lobe predominance (37.31%). Bajpai J et al. [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e] found cystic bronchiectasis more common in non-tubercular cases (86.36% vs. 66.67%, p\u0026thinsp;=\u0026thinsp;0.014), while fibro-cavitary and \u0026ldquo;tram-track\u0026rdquo; changes were more frequent post-tuberculosis (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). These results collectively indicate that cystic and mixed bronchiectatic patterns with bilateral, multilobar distribution are the dominant radiological features, particularly in post-tuberculosis cases [\u003cspan additionalcitationids=\"CR31 CR32\" citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIn the present study of 136 patients, most were aged above 60 years, with a female predominance. A past history of tuberculosis was seen in 36.1%, and diabetes mellitus was the most common co-morbidity. The most common radiological pattern was cystic bronchiectasis, and Pseudomonas aeruginosa was the predominant coloniser. This study highlights the clinical, radiological, and microbiological profile for better management of bronchiectasis.\u003c/p\u003e\n\u003ch3\u003eLimitations\u003c/h3\u003e\n\u003cp\u003e\u0026bull; Being a single center study, the findings of study could not be generalized\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026bull; Limited Sample size, thus studies with larger sample size are recommended to further\u0026nbsp;\u003c/p\u003e\n\u003cp\u003estrengthen our findings.\u003c/p\u003e\n\u003cp\u003e\u0026bull; Lack of comparative group which could have further broadened the knowledge on\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ebronchiectasis.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eBronchiectasis in this study predominantly affected elderly females, with post-tuberculosis sequelae as the leading etiology. Cough, sputum production, and dyspnea were the most common symptoms, while spirometry revealed a mixed ventilatory defect in the majority. HRCT demonstrated mainly cystic and bilateral lower lobe involvement, reflecting advanced structural lung damage. Pseudomonas aeruginosa was the most frequent isolate, associated with severe and cystic disease patterns. Overall, post-tuberculosis bronchiectasis with Pseudomonas colonization and mixed functional impairment defines the characteristic profile in this setting. Early identification and targeted antimicrobial management are essential to limit disease progression and improve outcomes.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cul\u003e\n \u003cli\u003eABPA \u0026ndash; Allergic Bronchopulmonary Aspergillosis\u003c/li\u003e\n \u003cli\u003eAFB \u0026ndash; Acid-Fast Bacilli\u003c/li\u003e\n \u003cli\u003eBAL \u0026ndash; Bronchoalveolar Lavage\u003c/li\u003e\n \u003cli\u003eBMI \u0026ndash; Body Mass Index\u003c/li\u003e\n \u003cli\u003eBSI \u0026ndash; Bronchiectasis Severity Index\u003c/li\u003e\n \u003cli\u003eCBNAAT \u0026ndash; Cartridge-Based Nucleic Acid Amplification Test\u003c/li\u003e\n \u003cli\u003eCF \u0026ndash; Cystic Fibrosis\u003c/li\u003e\n \u003cli\u003eCKD \u0026ndash; Chronic Kidney Disease\u003c/li\u003e\n \u003cli\u003eCOPD \u0026ndash; Chronic Obstructive Pulmonary Disease\u003c/li\u003e\n \u003cli\u003eCT \u0026ndash; Computed Tomography\u003c/li\u003e\n \u003cli\u003eCTD \u0026ndash; Connective Tissue Disease\u003c/li\u003e\n \u003cli\u003eDM \u0026ndash; Diabetes Mellitus\u003c/li\u003e\n \u003cli\u003eEMBARC \u0026ndash; European Multicentre Bronchiectasis Audit and Research Collaboration\u003c/li\u003e\n \u003cli\u003eFEV₁ \u0026ndash; Forced Expiratory Volume in One Second\u003c/li\u003e\n \u003cli\u003eFVC \u0026ndash; Forced Vital Capacity\u003c/li\u003e\n \u003cli\u003eHRCT \u0026ndash; High-Resolution Computed Tomography\u003c/li\u003e\n \u003cli\u003eIESC \u0026ndash; Institutional Ethics Subcommittee / Committee\u003c/li\u003e\n \u003cli\u003emMRC \u0026ndash; Modified Medical Research Council (Dyspnea Scale)\u003c/li\u003e\n \u003cli\u003eMS \u0026ndash; Microsoft\u003c/li\u003e\n \u003cli\u003eOPD \u0026ndash; Outpatient Department\u003c/li\u003e\n \u003cli\u003ePCD \u0026ndash; Primary Ciliary Dyskinesia\u003c/li\u003e\n \u003cli\u003eTB \u0026ndash; Tuberculosis\u003c/li\u003e\n \u003cli\u003eTLC \u0026ndash; Total Lung Capacity\u003c/li\u003e\n \u003cli\u003eUS \u0026ndash; United States\u003c/li\u003e\n \u003cli\u003eCAD \u0026ndash; Coronary Artery Disease\u003c/li\u003e\n \u003cli\u003eHRCT \u0026ndash;High Resolution Computed Tomography\u003c/li\u003e\n \u003cli\u003eHTN \u0026ndash; Hypertension\u003c/li\u003e\n \u003cli\u003eDM \u0026ndash; Diabetes Mellitus\u003c/li\u003e\n \u003cli\u003eP. aeruginosa \u0026ndash; Pseudomonas aeruginosa\u003c/li\u003e\n \u003cli\u003eK. pneumoniae \u0026ndash; Klebsiella pneumoniae\u003c/li\u003e\n \u003cli\u003eA. baumannii \u0026ndash; Acinetobacter baumannii\u003c/li\u003e\n \u003cli\u003eCFU \u0026ndash; Colony Forming Unit (implied in microbiology context)\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e: Not applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e: PD wrote the initial draft of the manuscript. SSD and PD managed the diagnosis and treatment. SSD wrote the original draft. SSD and PD reviewed and edited the draft. SSD and PD approved the final version of the manuscript and agreed to be accountable for all aspects of the work. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e The study received no external funding.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e: The datasets used and/or analyzed during the current study will be available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval\u003c/strong\u003e: The institutional review board approved the study. (Reference Number: \u0026nbsp; I.E.S.C./PGS/2023/65, Dated: 26/12/2023)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e: All individuals included in the study signed the informed consent \u0026nbsp; \u0026nbsp; for participation and publication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e: Nil\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eNigro M, Laska IF, Traversi L, et al. 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Regional variation in bronchiectasis imaging patterns: comparison of Asian and European cohorts. \u003cem\u003eRespir Res.\u003c/em\u003e 2023;24(1):45.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Bronchiectasis, Post-tuberculosis sequelae, Spirometry, Pseudomonas aeruginosa","lastPublishedDoi":"10.21203/rs.3.rs-7883591/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7883591/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eBronchiectasis is a chronic respiratory disorder characterized by irreversible bronchial dilatation, recurrent infections, and progressive lung damage. Varying etiological factors and clinical presentations geographically, necessitate region-specific studies. This study aims to assess the clinical, microbiological and radiological profile in patients with bronchiectasis at a tertiary care center.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eA cross-sectional study was conducted at Department of Respiratory Medicine, of a tertiary care hospital from February 2023 till September 2025. A total of 136 patients diagnosed with bronchiectasis were enrolled. Clinical evaluation, high-resolution computed tomography (HRCT) of the thorax, and microbiological assessment, including sputum and bronchoalveolar lavage (BAL) cultures along with spirometry were performed. The antimicrobial susceptibility of isolated pathogens was analyzed. Statistical analysis was conducted using descriptive methods.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eAmong 70 patients, 55.7% were female, and the majority (51.2%) was aged 61\u0026ndash;70 years. The most common symptoms included cough (73.2%), sputum production (70.7%), and dyspnea (60.9%). HRCT findings revealed a predominance of cystic (46.3%) and cylindrical (39%) patterns, with 65.9% of cases showing bilateral lung involvement. Microbiological analysis identified Pseudomonas aeruginosa (44.3%) as the most frequently isolated pathogen, followed by Klebsiella pneumoniae (27.1%). Patients with Pseudomonas aeruginosa exhibited more severe radiological involvement, including multilobar and cystic patterns. Spirometry analysis of the study participants revealed mixed (obstruction\u0026thinsp;+\u0026thinsp;restriction) pattern of air flow limitation (60%) followed by restrictive pattern (22%), while obstructive pattern was observed in 18% patients.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eThis study highlights the significant burden of bronchiectasis in elderly patients, with post-tuberculosis sequelae being a predominant etiological factor. Pseudomonas aeruginosa colonization is associated with more extensive radiological involvement, underscoring the need for targeted antimicrobial strategies. Comprehensive management approaches should address both underlying etiologies and associated co-morbidities to improve patient outcomes\u003c/p\u003e","manuscriptTitle":"Clinical, Radiological and Microbiological Profile of Bronchiectasis in Adults in a Tertiary Care Hospital: A Cross Sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-21 11:19:17","doi":"10.21203/rs.3.rs-7883591/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2c2ee083-aff2-4454-a1fd-cfd70aaa7e69","owner":[],"postedDate":"November 21st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-12-11T05:38:22+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-21 11:19:17","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7883591","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7883591","identity":"rs-7883591","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}