Prevalence and clinical significance of Staphylococcus aureus small-colony variants in cystic fibrosis lung disease
Prevalence and clinical significance of Staphylococcus aureus small-colony variants in cystic fibrosis lung disease
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DOI：
10.1128/jcm.01510-06
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发表时间：
2007-01-01
影响因子：
9.4
通讯作者：
Wichelhaus, Thomas A.
中科院分区：
文献类型：
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作者：
Besier, Silke;Smaczny, Christina;Wichelhaus, Thomas A.
金黄色葡萄球菌的小菌落变体（SCV）可以从患有囊性纤维化（CF）的患者的慢性感染的气道中分离。这些生长缓慢的形态学变异与持续性和耐药性感染相关，如骨髓炎和器械相关感染，但迄今为止尚无关于CF肺病中这种特殊表型的临床意义的信息。因此，我们调查了S。在一项为期12个月的前瞻性研究中，我们对CF肺病中的金黄色葡萄球菌SCV进行了研究，并将微生物培养结果与患者的临床数据相关联。共筛选了252例患者是否存在SCV。在S.金黄色葡萄球菌携带者。S.具有SCV表型的金黄色葡萄球菌分离株比具有正常表型的金黄色葡萄球菌分离株显示出显著更高的抗生素耐药率。SCV阳性的患者年龄明显较大（P = 0.0099），更常合并铜绿假单胞菌（P = 0.0454），并且显示出更晚期的疾病体征，例如与携带S的患者相比，1秒用力呼气量较低（P = 0.0148）。金黄色葡萄球菌，仅具有正常表型。Logistic回归模型确定较低体重（P = 0.016）、高龄（P = 0.000）和既往使用甲氧苄啶-磺胺甲恶唑（P = 0.002）为S.金黄色葡萄球菌SCV阳性。已知CF患者的临床状态受多个参数影响。尽管如此，这里确定的独立风险因素指向S的影响。金黄色葡萄球菌SCV对晚期CF肺病中慢性和持续性感染的作用。
Small-colony variants (SCVs) of Staphylococcus aureus can be isolated from the chronically infected airways of patients suffering from cystic fibrosis (CF). These slow-growing morphological variants have been associated with persistent and antibiotic-resistant infections, such as osteomyelitis and device-related infections, but no information is available to date regarding the clinical significance of this special phenotype in CF lung disease. We therefore investigated the prevalence of S. aureus SCVs in CF lung disease in a 12-month prospective study and correlated the microbiological culture results with the patients' clinical data. A total of 252 patients were screened for the presence of SCVs. The prevalence rate was determined to be 17% (95% confidence interval, 10 to 25%) among S. aureus carriers. S. aureus isolates with the SCV phenotype showed significantly higher antibiotic resistance rates than those with the normal phenotype. Patients positive for SCVs were significantly older (P = 0.0099), more commonly cocolonized with Pseudomonas aeruginosa (P = 0.0454), and showed signs of more advanced disease, such as lower forced expiratory volume in 1 s (P = 0.0148) than patients harboring S. aureus with a solely normal phenotype. The logistic regression model determined lower weight (P = 0.016), advanced age (P = 0.000), and prior use of trimethoprim-sulfamethoxazole (P = 0.002) as independent risk factors for S. aureus SCV positivity. The clinical status of CF patients is known to be affected by multiple parameters. Nonetheless, the independent risk factors determined here point to the impact of S. aureus SCVs on chronic and persistent infections in advanced CF lung disease.