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囊性纤维化患者呼吸道细菌学的流行病学变化

Changing Epidemiology of the Respiratory Bacteriology of Patients With Cystic Fibrosis.

作者信息

Salsgiver Elizabeth L, Fink Aliza K, Knapp Emily A, LiPuma John J, Olivier Kenneth N, Marshall Bruce C, Saiman Lisa

机构信息

Columbia University Medical Center, New York, NY.

Cystic Fibrosis Foundation, Bethesda, MD.

出版信息

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

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.

摘要

背景

监测囊性纤维化(CF)病原体流行病学的潜在变化有助于我们了解干预措施的潜在影响。

方法

我们利用2006年至2012年向囊性纤维化基金会患者登记处(CFFPR)报告的数据进行回顾性分析,以确定选定CF病原体患病率和发病率的年度百分比变化。病原体包括铜绿假单胞菌、甲氧西林敏感金黄色葡萄球菌(MSSA)、甲氧西林耐药金黄色葡萄球菌(MRSA)、流感嗜血杆菌、洋葱伯克霍尔德菌复合体、嗜麦芽窄食单胞菌和木糖氧化无色杆菌。2010年至2012年,当CFFPR收集非结核分枝杆菌(NTM)种类时,评估了NTM患病率的变化。

结果

2012年,患病率和发病率最高的病原体是MSSA和铜绿假单胞菌,其次是MRSA。木糖氧化无色杆菌和洋葱伯克霍尔德菌复合体的患病率相对较低。2006年至2012年,铜绿假单胞菌和洋葱伯克霍尔德菌复合体总体(以及大多数年龄组)患病率和发病率的年度百分比变化显著下降,但MRSA显著上升。2010年至2012年,NTM和鸟分枝杆菌复合体总体患病率的年度百分比变化增加。

结论

CF病原体的流行病学在持续变化。这些观察结果的原因很可能是多因素的,包括临床护理以及感染预防和控制方面的改善。本研究的数据将有助于评估新疗法对CF微生物学的影响。

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