Outcomes and Treatment of Chronic Methicillin-Resistant Staphylococcus aureus Differs by Staphylococcal Cassette Chromosome mec (SCCmec) Type in Children With Cystic Fibrosis

Journal of the Pediatric Infectious Diseases Society
Sonya L HeltsheM S Muhlebach

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) infects ∼25% of patients with cystic fibrosis (CF) in the United States. We hypothesized that health-related outcomes differed between healthcare-associated (staphylococcal cassette chromosome mec [SCCmec] II) vs community-associated (SCCmec IV) MRSA strains in patients chronically infected with CF. At 7 CF centers, MRSA isolates were prospectively obtained from patients ≤18 years old with 2 or more positive MRSA cultures within 1 year. Isolates were classified by SCCmec type and Panton-Valentine-leukocidin (PVL) status at a core laboratory, and sites remained blinded to SCCmec type and PVL results. Prospective clinical data including antibiotic use, respiratory symptoms, and pulmonary exacerbations were obtained. Among the 295 cohort participants with typeable MRSA isolates, 69.5% had SCCmec II PVL(-), 13.2% had SCCmec IV PVL(-), and 17.3% had SCCmec IV PVL(+) strains. During follow-up of 287 patients with prospective data after enrollment, the risk for pulmonary exacerbations was significantly higher among participants with SCCmec II than SCCmec IV strains (risk ratio [RR] = 1.13; P = .03) and higher in those with SCCmec IV PVL(-) than SCCmec IV PVL(+) strains (RR = 1.62; P <...Continue Reading

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Citations

Jun 28, 2016·Therapeutic Advances in Chronic Disease·Claire Edmondson, Jane C Davies
Aug 4, 2018·Pediatric Pulmonology·Nour Akil, Marianne S Muhlebach
May 10, 2018·The Pediatric Infectious Disease Journal·Nicholas M FuscoCalvin J Meaney
Aug 11, 2017·Current Opinion in Pulmonary Medicine·Marianne S Muhlebach
Nov 18, 2016·Thorax·Marianne Sponer MuhlebachUNKNOWN STAR-too study team
Apr 24, 2019·Pediatric Pulmonology·Sachinkumar B SinghAnthony J Fischer
Jun 10, 2021·Journal of Cystic Fibrosis : Official Journal of the European Cystic Fibrosis Society·Deirdre GilpinMarianne S Muhlebach
Jul 6, 2021·Pediatric Pulmonology·Harry S PorterfieldAnthony J Fischer
Aug 31, 2021·Journal of Cystic Fibrosis : Official Journal of the European Cystic Fibrosis Society·Marianne S MuhlebachLisa Saiman

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