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Observational Study
. 2016 Feb;149(2):390-400.
doi: 10.1378/chest.15-0676. Epub 2016 Jan 12.

Changing Epidemiology of the Respiratory Bacteriology of Patients With Cystic Fibrosis

Elizabeth L Salsgiver  1 , Aliza K Fink  2 , Emily A Knapp  2 , John J LiPuma  3 , Kenneth N Olivier  4 , Bruce C Marshall  2 , Lisa Saiman  5
Affiliations
Observational Study

Changing Epidemiology of the Respiratory Bacteriology of Patients With Cystic Fibrosis

Elizabeth L Salsgiver et al. Chest. 2016 Feb.

Abstract

Background: Monitoring potential changes in the epidemiology of cystic fibrosis (CF) pathogens furthers our understanding of the potential impact of interventions.

Methods: We performed a retrospective analysis using data reported to the Cystic Fibrosis Foundation Patient Registry (CFFPR) from 2006 to 2012 to determine the annual percent changes in the prevalence and incidence of selected CF pathogens. Pathogens included Pseudomonas aeruginosa, methicillin-susceptible Staphylococcus aureus (MSSA), methicillin-resistant S aureus (MRSA), Haemophilus influenzae, Burkholderia cepacia complex, Stenotrophomonas maltophilia, and Achromobacter xylosoxidans. Changes in nontuberculous mycobacteria (NTM) prevalence were assessed from 2010 to 2012, when the CFFPR collected NTM species.

Results: In 2012, the pathogens of highest prevalence and incidence were MSSA and P aeruginosa, followed by MRSA. The prevalence of A xylosoxidans and B cepacia complex were relatively low. From 2006 to 2012, the annual percent change in overall (as well as in most age strata) prevalence and incidence significantly decreased for P aeruginosa and B cepacia complex, but significantly increased for MRSA. From 2010 to 2012, the annual percent change in overall prevalence of NTM and Mycobaterium avium complex increased.

Conclusions: The epidemiology of CF pathogens continues to change. The causes of these observations are most likely multifactorial and include improvements in clinical care and infection prevention and control. Data from this study will be useful to evaluate the impact of new therapies on CF microbiology.

Keywords: Pseudomonas aeruginosa; Staphylococcus aureus; cystic fibrosis; registry.

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Figures

Figure 1
Figure 1
Flow diagram of eligible patients. Patients in the Cystic Fibrosis Foundation Patient Registry eligible for current study and number of years of participation.
Figure 2
Figure 2
A, Overall incidence and prevalence of Pseudomonas aeruginosa in patients with CF from 2006 to 2012. The overall incidence and prevalence of P aeruginosa among these patients is shown by age strata. B, Overall incidence and prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in patients with cystic fibrosis from 2006 to 2012. The overall incidence and prevalence of MRSA among these patients is shown by age strata. These data reflect an analysis of the US Cystic Fibrosis Foundation Patient Registry.
See this image and copyright information in PMC

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