The impact of methicillin-resistant Staphylococcus aureus colonisation on paediatric cystic fibrosis patients' morbidity.
BACKGROUND
Methicillin-resistant Staphylococcus aureus (MRSA) plays a well-recognised pathogenic role in cystic fibrosis (CF).


OBJECTIVE
To evaluate the prevalence and incidence of colonisation by MRSA, clinical impact of MRSA colonisation (year after first MRSA isolation), risk factors and pattern of antimicrobial resistance.


METHODS
Retrospective review of paediatric CF patients colonised with MRSA followed-up at the CF Unit of Hospital de Santa Maria 2003-2007.


RESULTS
Twelve of the 60 patients followed-up during this period were MRSA-positive at some time (chronic colonisation in 3 patients). Mean age at acquisition was 9 years 10 months and mean time interval between CF diagnosis and MRSA acquisition 5 years 7 months. An important rise in MRSA colonisation prevalence and incidence was observed, with the highest rate seen in 2007 (prevalence 14.3% and incidence 8.9%). Four patients had received anti-staphylococcal prophylaxis with flucloxacillin. An increase in the total number of in-patient days was observed in four patients (two with chronic colonisation). Deterioration in lung function was seen in five patients (including the three patients with chronic colonisation). Only one patient had a decrease in body mass index percentile. Resistance to clindamycin and rifampin was the most frequently seen.


CONCLUSIONS
This study revealed significant clinical deterioration in patients with chronic colonisation by MRSA, reinforcing the importance of effective and timely decolonisation strategies.
Fermeiro
Joana
J
Departamento da Criança e da Família do Hospital de Santa Maria, Lisboa. jsnfermeiro@hotmail.com
Reis
Patrícia
P
Castanhinha
Susana
S
Pereira
Luísa
L
Barreto
Celeste
C
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000150:complications / Q000382:microbiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000472:pathogenicity*; D015995:Prevalence; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology*