title: Chest computed tomography scores in patients with cystic fibrosis colonized with methicillin-resistant Staphylococcus aureus.
abstract: BACKGROUND
  Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen in cystic fibrosis (CF), with increasing incidence in recent years. We examined the association between bacterial colonization in the sputum (MRSA with or without pseudomonas (PA)) and computed tomography (CT) scores in CF patients.
  
  
  METHODS
  MRSA patients were divided according to PA status based on at least three consecutive sputum cultures; controls were patients without MRSA (with or without PA), matched for gender and age at CT. Clinical data and CT scores were compared between groups.
  
  
  RESULTS
  Of 33 patients with MRSA, 14 had no PA (MRSA + PA-) and 19 had also PA (MRSA + PA+). MRSA + PA- and MRSA + PA+ patients had CT scores similar to their controls PA+ (38.25 ± 20.18 vs. 32.22 ± 18.74, P = .4, and 41.88 ± 18.18 vs. 45.33 ± 11.5, P = .4, respectively). Although MRSA + PA- had worse CT scores than their matched PA- controls, their mean FEV1 values were similar.
  
  
  CONCLUSIONS
  Colonization with MRSA in CF is associated with structural CT changes at least similar to those in PA. A cause and effect relationship cannot be established. The current findings call for a larger study assessing longitudinally the impact of MRSA acquisition and eradication protocols.
authors.affiliation: Centro Regionale Fibrosi Cistica, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.
authors.forename: Michal
authors.initials: M
authors.lastname: Gur
authors.affiliation: Centro Regionale Fibrosi Cistica, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Spinelli
authors.affiliation: Centro Regionale Fibrosi Cistica, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.
authors.forename: Gloria
authors.initials: G
authors.lastname: Tridello
authors.affiliation: Unità operativa di Radiologia, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.
authors.forename: Susanna
authors.initials: S
authors.lastname: Baltieri
authors.affiliation: Unità operativa di Radiologia, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Pinali
authors.affiliation: Unità operativa di Radiologia, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Montemezzi
authors.affiliation: Ruth Rappaport Children's Hospital, Pediatric Pulmonary Institute and CF Center, Haifa, Israel.|The Rappaport Faculty of Medicine, Technion-Israel Institute of Technology Haifa, Haifa, Israel.
authors.forename: Lea
authors.initials: L
authors.lastname: Bentur
authors.affiliation: Centro Regionale Fibrosi Cistica, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.
authors.forename: Baroukh Maurice
authors.initials: BM
authors.lastname: Assael
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002648:Child; D003430:Cross-Sectional Studies; D003550:Cystic Fibrosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects* / Q000472:pathogenicity; D008826:Microbial Sensitivity Tests; D011023:Pneumonia, Staphylococcal / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: MRSA; PA; chest CT; cystic fibrosis; lung infection; severity score