Persistent methicillin-resistant Staphylococcus aureus and rate of FEV 1 decline in cystic fibrosis

Elliott C. Dasenbrook, Christian A. Merlo, Marie Diener-West, Noah Lechtzin, Michael P. Boyle

Research output: Contribution to journalArticlepeer-review

Abstract

Rationale:Theprevalence 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 MRSAon FEV1 decline in CF is unknown. Objectives: To determine the association between MRSA respiratory infection and FEV1 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 FEV1 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 (≥3 MRSA cultures; average, 6.8 positive cultures) and were subsequently followed foran average of 3.5 years. Even after adjustment for confounders, rate of FEV1 decline in individuals aged 8-21 years with persistent MRSA was more rapid in both statistical models. Their average FEV1 decline of 2.06% predicted/year was 43% more rapid than the 1.44% predicted/year in those without MRSA (difference, 20.62% predicted/yr; 95% confidence interval, 20.70 to -0.54; P < 0.001). Effect of MRSA on FEV1 decline in adults was not clinically significant. Conclusions: Persistent infection with MRSA in individuals with CF betweenthe agesof 8 and 21 years is associated with a more rapidrate of decline in lung function.

Original languageEnglish (US)
Pages (from-to)814-821
Number of pages8
JournalAmerican journal of respiratory and critical care medicine
Volume178
Issue number8
DOIs
StatePublished - Oct 15 2008

Keywords

  • Cystic fibrosis
  • Epidemiology
  • Longitudinal studies
  • Methicillin-resistant Staphylococcus aureus
  • Pulmonary function test

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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