Respiratory Microbiology of Patients With Cystic Fibrosis in the United States, 1995 to 2005
Respiratory Microbiology of Patients With Cystic Fibrosis in the United States, 1995 to 2005
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DOI：
10.1378/chest.09-0132
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发表时间：
2009-12-01
期刊：
影响因子：
9.6
通讯作者：
Saiman, Lisa
中科院分区：
文献类型：
--
作者：
Razvi, Samiya;Quittell, Lynne;Saiman, Lisa
背景：过去 20 年来，囊性纤维化 (CF) 患者的诊断和治疗策略取得了许多进展。我们假设这些变化可能会影响呼吸道微生物学的趋势。方法：囊性纤维化基金会患者登记处的数据用于检查 1995 年至 2005 年美国 CF 患者中分离出的细菌病原体的发病率和流行趋势。结果：患者登记处的 CF 患者人数从 1995 年的 19,735 人增加到 2005 年的 23,347 人。据报道，铜绿假单胞菌的年患病率从 1995 年的 60.4% 显着下降到 2005 年的 56.1% (p < 0.001)。 6至10岁儿童（48.2%至36.1%）和11岁至17岁青少年（68.9%至55.5%）下降最为明显。甲氧西林敏感金黄色葡萄球菌的发病率（1995年为21.7%，2005年为33.2%）和患病率（1995年为37.0%，2005年为52.4%）均显着增加，其中6～17岁患者的年龄别患病率最高。耐甲氧西林金黄色葡萄球菌的患病率从1995年的0.1%上升到2005年的17.2%，2002年至2005年在11至17岁青少年中最高。洋葱伯克霍尔德杆菌复合群的患病率和发病率均下降，而流感嗜血杆菌、嗜麦芽寡养单胞菌和木糖氧化产碱菌的患病率上升。结论：来自患者登记的数据表明，CF患者的细菌病原体流行病学在研究期间发生了变化。未来的研究应继续监测不断变化的趋势，并确定这些趋势与 CF 护理实践之间的关联。 （胸部 2009 年；136：1554-1560）
Background: Numerous improvements in diagnostic and therapeutic strategies for patients with cystic fibrosis (CF) have occurred during the past 2 decades. We hypothesized that these changes could impact trends in respiratory microbiology.Methods: Data from the Cystic Fibrosis Foundation Patient Registry were used to examine trends in the incidence and prevalence of bacterial pathogens isolated from patients with CF in the United States from 1995 to 2005.Results: The number of patients with CF in the patient registry increased from 19,735 in 1995 to 23,347 in 2005. During the study period, the reported annual prevalence of Pseudomonas aeruginosa significantly declined from 60.4% in 1995 to 56.1% in 2005 (p < 0.001). The decline was most marked in children 6 to 10 years old (48.2 to 36.1%) and adolescents I I to 17 years old (68.9 to 55.5%). Both the incidence (21.7% in 1995 and 33.2% in 2005) and prevalence (37.0% in 1995 and 52.4% in 2005) of methicillin-susceptible Staphylococcus aureus significantly increased and the age-specific prevalence was highest in patients 6 to 17 years old. The prevalence of methicillin-resistant S aureus increased from 0.1% in 1995 to 17.2% in 2005 and from 2002 to 2005 was highest in adolescents 11 to 17 years old. Both the prevalence and incidence of Burkholderia cepacia complex declined, while the prevalence of Haemophilus influenzae, Stenotrophomonas maltophilia, and Alcaligenes xylosoxidans increased.Conclusions: Data from the patient registry suggest that the epidemiology of bacterial pathogens in patients with CF changed during the study period. Future studies should continue to monitor changing trends and define the association between these trends and care practices in CF. (CHEST 2009; 136:1554-1560)