Rationale: Infection is a key disease driver in bronchiectasis, and the upper-airway microbiome has been known to shape the lower-airway microbiome. Objective: To evaluate the relationship between the upper-airway microbiome, mucociliary function, and clinical outcomes in bronchiectasis. Methods: Nasopharyngeal swabs were collected from 344 patients with bronchiectasis enrolled across five European centers. A total of 104 patients had nasopharyngeal samples obtained at the 1-year follow-up. Microbiome composition was assessed according to Bronchiectasis Severity Index and severe exacerbations. The
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