T
tammykrumrey
Guest
Here is a copy of a study that was done in regards to MRSA. I get these email updates from a MDLinx Pulmonology every day when Cystic Fibrosis is mentioned. Just thought I would pass on the information.
Persistent Methicillin-resistant Staphylococcus aureus and Rate of FEV1 Decline in Cystic Fibrosis
Elliott C. Dasenbrook1, Christian A. Merlo1, Marie Diener-West2, Noah Lechtzin1 and Michael P. Boyle1
1 Division of Pulmonary and Critical Care Medicine, Department of Medicine, The Johns Hopkins University School of Medicine, and 2 Departments of Biostatistics and Epidemiology, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
Correspondence and requests for reprints should be addressed to Elliott C. Dasenbrook, M.D., The Johns Hopkins University School of Medicine, 1830 E. Monument Street, 5th Floor, Baltimore, MD 21205. E-mail: edasenb1@jhmi.edu
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 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 for an 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, - 0.62% predicted/yr; 95% confidence interval, - 0.70 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 between the ages of 8 and 21 years is associated with a more rapid rate of decline in lung function.
Persistent Methicillin-resistant Staphylococcus aureus and Rate of FEV1 Decline in Cystic Fibrosis
Elliott C. Dasenbrook1, Christian A. Merlo1, Marie Diener-West2, Noah Lechtzin1 and Michael P. Boyle1
1 Division of Pulmonary and Critical Care Medicine, Department of Medicine, The Johns Hopkins University School of Medicine, and 2 Departments of Biostatistics and Epidemiology, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
Correspondence and requests for reprints should be addressed to Elliott C. Dasenbrook, M.D., The Johns Hopkins University School of Medicine, 1830 E. Monument Street, 5th Floor, Baltimore, MD 21205. E-mail: edasenb1@jhmi.edu
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 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 for an 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, - 0.62% predicted/yr; 95% confidence interval, - 0.70 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 between the ages of 8 and 21 years is associated with a more rapid rate of decline in lung function.