Document Detail


Persistent methicillin-resistant Staphylococcus aureus and rate of FEV1 decline in cystic fibrosis.
MedLine Citation:
PMID:  18669817     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
RATIONALE: The prevalence in cystic fibrosis (CF) of respiratory cultures with methicillin-resistant Staphylococcus aureus (MRSA) has dramatically increased over the last 10 years, but the effect of MRSA on FEV(1) decline in CF is unknown. OBJECTIVES: To determine the association between MRSA respiratory infection and FEV(1) decline in children and adults with CF. METHODS: This was a 10-year cohort study using the Cystic Fibrosis Foundation patient registry from 1996-2005. We studied individuals who developed new MRSA respiratory tract infection. Repeated-measures regression was used to assess the association between MRSA and FEV(1) decline, adjusted for confounders, in individuals aged 8-21 years and adults (aged 22-45 yr). Two different statistical models were used to assess robustness of results. MEASUREMENTS AND MAIN RESULTS: The study cohort included 17,357 patients with an average follow-up of 5.3 years. During the study period, 1,732 individuals developed new persistent MRSA infection (> or =3 MRSA cultures; average, 6.8 positive cultures) and were subsequently followed for an average of 3.5 years. Even after adjustment for confounders, rate of FEV(1) decline in individuals aged 8-21 years with persistent MRSA was more rapid in both statistical models. Their average FEV(1) decline of 2.06% predicted/year was 43% more rapid than the 1.44% predicted/year in those without MRSA (difference, -0.62% predicted/yr; 95% confidence interval, -0.70 to -0.54; P < 0.001). Effect of MRSA on FEV(1) decline in adults was not clinically significant. CONCLUSIONS: Persistent infection with MRSA in individuals with CF between the ages of 8 and 21 years is associated with a more rapid rate of decline in lung function.
Authors:
Elliott C Dasenbrook; Christian A Merlo; Marie Diener-West; Noah Lechtzin; Michael P Boyle
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2008-07-31
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  178     ISSN:  1535-4970     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-03     Completed Date:  2008-10-21     Revised Date:  2009-04-16    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  814-21     Citation Subset:  AIM; IM    
Affiliation:
Division of Pulmonary and Critical Care Medicine, Department of Medicine, The Johns Hopkins University School of Medicine, 1830 E. Monument Street, 5th Floor, Baltimore, MD 21205, USA. edasenb1@jhmi.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Child
Cystic Fibrosis / complications,  physiopathology*
Female
Follow-Up Studies
Forced Expiratory Volume / physiology*
Humans
Male
Methicillin Resistance*
Middle Aged
Prevalence
Prognosis
Retrospective Studies
Staphylococcal Infections / complications*,  epidemiology,  physiopathology
Staphylococcus aureus / isolation & purification*
Time Factors
United States
Comments/Corrections
Comment In:
Am J Respir Crit Care Med. 2009 Apr 15;179(8):734-5; author reply 735   [PMID:  19351873 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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