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.
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: Rebecca A Keel; Andre Schaeftlein; Charlotte Kloft; J Samuel Pope; R Frederic Knauft; Marianne Muhlebach; David P Nicolau; Joseph L Kuti Journal: Antimicrob Agents Chemother Date: 2011-04-25 Impact factor: 5.191
Authors: Theodore G Liou; Eric P Elkin; David J Pasta; Joan R Jacobs; Michael W Konstan; Wayne J Morgan; Jeffrey S Wagener Journal: J Cyst Fibros Date: 2010-05-14 Impact factor: 5.482
Authors: Edith T Zemanick; J Kirk Harris; Steven Conway; Michael W Konstan; Bruce Marshall; Alexandra L Quittner; George Retsch-Bogart; Lisa Saiman; Frank J Accurso Journal: J Cyst Fibros Date: 2009-10-14 Impact factor: 5.482
Authors: Deanna M Green; Kathryn E McDougal; Scott M Blackman; Patrick R Sosnay; Lindsay B Henderson; Kathleen M Naughton; J Michael Collaco; Garry R Cutting Journal: Respir Res Date: 2010-10-08