期刊论文详细信息
BMC Pulmonary Medicine
Clinical outcomes associated with Staphylococcus aureus and Pseudomonas aeruginosa airway infections in adult cystic fibrosis patients
Dao Nguyen3  Simon Rousseau3  Larry C. Lands4  Danuta Radzioch2  Elias Matouk1  Joanie Bernier1  Jennifer S. Landry5  Andrea Benedetti5  Heather G. Ahlgren6 
[1] Adult CF clinic, McGill University Health Center, Montreal, Canada;Department of Human Genetics, McGill University, Montreal, Canada;Department of Medicine, McGill University Health Center Research Institute, Montreal, Canada;Department of Pediatrics, McGill University Health Center Research Institute, Montreal, Canada;Respiratory Epidemiology and Clinical Research Unit, McGill University Health Center, Montreal, Canada;Department of Medicine, McGill University, Montreal, Canada
关键词: Retrospective cohort;    Pulmonary exacerbation;    Lung function;    Pseudomonas aeruginosa;    Staphylococcus aureus;    Microbiology;    Cystic fibrosis;   
Others  :  1216157
DOI  :  10.1186/s12890-015-0062-7
 received in 2015-03-12, accepted in 2015-06-10,  发布年份 2015
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【 摘 要 】

Background

Staphylococcus aureus (SA) is the most prevalent organism infecting the respiratory tract of CF children, and remains the second most prevalent organism in CF adults. During early childhood, SA infections are associated with pulmonary inflammation and decline in FEV 1 , but their clinical significance in adult CF patients is poorly characterized.

Methods

We conducted a retrospective cross-sectional study to determine the association between airway microbiology and clinical outcomes (FEV 1 , rate of pulmonary exacerbations, CRP levels and clinical scores).

Results

In a cohort of 84 adult CF patients, 24 % were infected with SA only, 60 % were infected with PA, and 16 % had neither PA nor SA. CF patients with SA experienced fewer pulmonary exacerbations and lower CRP levels than those with PA.

Conclusion

In adult CF patients, SA infections alone, in the absence of PA, are a marker of milder disease.

【 授权许可】

   
2015 Ahlgren et al.

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【 参考文献 】
  • [1]Gibson RL, Burns JL, Ramsey BW. Pathophysiology and management of pulmonary infections in cystic fibrosis. Am J Respir Crit Care Med. 2003; 168(8):918-51.
  • [2]Lipuma JJ. The changing microbial epidemiology in cystic fibrosis. Clin Microbiol Rev. 2010; 23(2):299-323.
  • [3]Lyczak JB, Cannon CL, Pier GB. Lung infections associated with cystic fibrosis. Clin Microbiol Rev. 2002; 15(2):194-222.
  • [4](US) CFF. Patient Registry Annual Data Report 2012. Bethesda, Maryland: Cystic Fibrosis Foundation Patient Registry; 2012.
  • [5]Kerem E, Corey M, Gold R, Levison H. Pulmonary function and clinical course in patients with cystic fibrosis after pulmonary colonization with Pseudomonas aeruginosa. J Pediatr. 1990; 116(5):714-9.
  • [6]Nixon GM, Armstrong DS, Carzino R, Carlin JB, Olinsky A, Robertson CF et al.. Clinical outcome after early Pseudomonas aeruginosa infection in cystic fibrosis. J Pediatrics. 2001; 138(5):699-704.
  • [7]Li ZKMR. LOngitudinal development of mucoid pseudomonas aeruginosa infection and lung disease progression in children with cystic fibrosis. JAMA. 2005; 293(5):581-588.
  • [8]Rosenfeld M, Emerson J, Accurso F, Armstrong D, Castile R, Grimwood K et al.. Diagnostic accuracy of oropharyngeal cultures in infants and young children with cystic fibrosis. Pediatric Pulmonol. 1999; 28(5):321-328.
  • [9]Razvi S, Quittell L, Sewall A, Quinton H, Marshall B, Saiman L. Respiratory microbiology of patients with cystic fibrosis in the United States, 1995 to 2005. Chest. 2009; 136(6):1554-60.
  • [10]Wong JK, Ranganathan SC, Hart E. Staphylococcus aureus in early cystic fibrosis lung disease. Pediatr Pulmonol. 2013; 48(12):1151-9.
  • [11]Hudson VL, Wielinski CL, Regelmann WE. Prognostic implications of initial oropharyngeal bacterial flora in patients with cystic fibrosis diagnosed before the age of two years. J Pediatr. 1993; 122(6):854-60.
  • [12]Pillarisetti N, Williamson E, Linnane B, Skoric B, Robertson CF, Robinson P et al.. Infection, inflammation, and lung function decline in infants with cystic fibrosis. Am J Respir Crit Care Med. 2011; 184(1):75-81.
  • [13]Glikman D, Siegel JD, David MZ, Okoro NM, Boyle-Vavra S, Dowell ML et al.. Complex molecular epidemiology of methicillin-resistant staphylococcus aureus isolates from children with cystic fibrosis in the era of epidemic community-associated methicillin-resistant S aureus. Chest. 2008; 133(6):1381-7.
  • [14]Sly PD, Brennan S, Gangell C, de Klerk N, Murray C, Mott L et al.. Lung disease at diagnosis in infants with cystic fibrosis detected by newborn screening. Am J Respir Crit Care Med. 2009; 180(2):146-52.
  • [15]Sagel SD, Gibson RL, Emerson J, McNamara S, Burns JL, Wagener JS et al.. Impact of Pseudomonas and Staphylococcus infection on inflammation and clinical status in young children with cystic fibrosis. J Pediatr. 2009; 154(2):183-8.
  • [16]Gangell C, Gard S, Douglas T, Park J, Klerk N, Keil T et al.. Inflammatory Responses to Individual Microorganisms in the Lungs of Children With Cystic Fibrosis. Clin Infect Dis. 2011; 53(5):425-32.
  • [17]Saiman L, Siegel J, Cystic Fibrosis F. Infection control recommendations for patients with cystic fibrosis: microbiology, important pathogens, and infection control practices to prevent patient-to-patient transmission. Infect Control Hosp Epidemiol. 2003; 24(5 Suppl):S6-52.
  • [18]Smyth A. Prophylactic antibiotics in cystic fibrosis: a conviction without evidence? Pediatr Pulmonol. 2005; 40(6):471-6.
  • [19]Goss CH, Muhlebach MS. Review: Staphylococcus aureus and MRSA in cystic fibrosis. J Cystic Fibrosis. 2011; 10(5):298-306.
  • [20]McCaffery K, Olver RE, Franklin M, Mukhopadhyay S. Systematic review of antistaphylococcal antibiotic therapy in cystic fibrosis. Thorax. 1999; 54(5):380-3.
  • [21]Liou TG, Adler FR, Cox DR, Cahill BC. Lung transplantation and survival in children with cystic fibrosis. N Engl J Med. 2007; 357(21):2143-52.
  • [22]Liou TG, Adler FR, FitzSimmons SC, Cahill BC, Hibbs JR, Marshall BC. Predictive 5-Year Survivorship Model of Cystic Fibrosis. Am J Epidemiol. 2001; 153(4):345-352.
  • [23]Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A et al.. Standardisation of spirometry. Eur Respir J. 2005; 26(2):319-38.
  • [24]Matouk E, Ghezzo RH, Gruber J, Hidvegi R, Gray-Donald K. Internal consistency reliability and predictive validity of a modified N. Huang clinical scoring system in adult cystic fibrosis patients. Eur Res J. 1997; 10(9):2004-2013.
  • [25]Matouk E, Ghezzo RH, Gruber J, Hidvegi R, Gray-Donald K. Construct and longitudinal validity of a modified Huang clinical scoring system in adult cystic fibrosis patients. Eur Respir J. 1999; 13(3):552-9.
  • [26]Armstrong DS, Grimwood K, Carlin JB, Carzino R, Olinsky A, Phelan PD. Bronchoalveolar lavage or oropharyngeal cultures to identify lower respiratory pathogens in infants with cystic fibrosis. Pediatr Pulmonol. 1996; 21(5):267-75.
  • [27]Bodini A, D’Orazio C, Peroni D, Corradi M, Folesani G, Baraldi E et al.. Biomarkers of neutrophilic inflammation in exhaled air of cystic fibrosis children with bacterial airway infections. Pediatr Pulmonol. 2005; 40(6):494-9.
  • [28]Dalboge CS, Pressler T, Hoiby N, Nielsen KG, Johansen HK. A cohort study of the Copenhagen CF Centre eradication strategy against Staphylococcus aureus in patients with CF. J Cystic Fibrosis. 2013; 12(1):42-8.
  • [29]Beardsmore CS, Thompson JR, Williams A, McArdle EK, Gregory GA, Weaver LT et al.. Pulmonary function in infants with cystic fibrosis: the effect of antibiotic treatment. Arch Dis Child. 1994; 71(2):133-7.
  • [30]Stutman HR, Lieberman JM, Nussbaum E, Marks MI. Antibiotic prophylaxis in infants and young children with cystic fibrosis: a randomized controlled trial. J Pediatr. 2002; 140(3):299-305.
  • [31]Weaver LT, Green MR, Nicholson K, Mills J, Heeley ME, Kuzemko JA et al.. Prognosis in cystic fibrosis treated with continuous flucloxacillin from the neonatal period. Arch Dis Child. 1994; 70(2):84-9.
  • [32]Liou TG, Adler FR, Fitzsimmons SC, Cahill BC, Hibbs JR, Marshall BC. Predictive 5-year survivorship model of cystic fibrosis. Am J Epidemiol. 2001; 153(4):345-52.
  • [33]Britto MT, Kotagal UR, Hornung RW, Atherton HD, Tsevat J, Wilmott RW. Impact of recent pulmonary exacerbations on quality of life in patients with cystic fibrosis. Chest. 2002; 121(1):64-72.
  • [34]Schluchter MD, Konstan MW, Davis PB. Jointly modelling the relationship between survival and pulmonary function in cystic fibrosis patients. Stat Med. 2002; 21(9):1271-87.
  • [35]Kerem E, Viviani L, Zolin A, Macneill S, Hatziagorou E, Ellemunter H, et al. Factors associated with FEV1 decline in cystic fibrosis: analysis of the data of the ECFS Patient Registry. Eur Respir J. 2014;43(1):125–33.
  • [36]Dasenbrook Ec CW. ASsociation between respiratory tract methicillin-resistant staphylococcus aureus and survival in cystic fibrosis. JAMA. 2010;303(23):2386–92.
  • [37]Dasenbrook EC. Update on methicillin-resistant Staphylococcus aureus in cystic fibrosis. Curr Opin Pulm Med. 2011; 17(6):437-41.
  • [38]Canadian Cystic Fibrosis Patient Registry 2012 Annual Data Report. Cystic Fibrosis Canada, Toronto, Ontario, Canada; 2012:1–34.
  • [39]Dasenbrook EC, Merlo CA, Diener-West M, Lechtzin N, Boyle MP. Persistent methicillin-resistant Staphylococcus aureus and rate of FEV1 decline in cystic fibrosis. Am J Respir Crit Care Med. 2008; 178(8):814-21.
  • [40]Sanders DB, Bittner RC, Rosenfeld M, Hoffman LR, Redding GJ, Goss CH. Failure to recover to baseline pulmonary function after cystic fibrosis pulmonary exacerbation. Am J Respir Crit Care Med. 2010; 182(5):627-32.
  • [41]Hoffman LR, Deziel E, D’Argenio DA, Lepine F, Emerson J, McNamara S et al.. Selection for Staphylococcus aureus small-colony variants due to growth in the presence of Pseudomonas aeruginosa. Proc Natl Acad Sci U S A. 2006; 103(52):19890-5.
  • [42]Wolter DJ, Emerson JC, McNamara S, Buccat AM, Qin X, Cochrane E et al.. Staphylococcus aureus small-colony variants are independently associated with worse lung disease in children with cystic fibrosis. Clin Infect Dis. 2013; 57(3):384-391.
  • [43]Besier S, Smaczny C, von Mallinckrodt C, Krahl A, Ackermann H, Brade V et al.. Prevalence and clinical significance of Staphylococcus aureus small-colony variants in cystic fibrosis lung disease. J Clin Microbiol. 2007; 45(1):168-72.
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