From Our 2010 Archives

Drug-Resistant Staph Threatens Cystic Fibrosis Patients

TUESDAY, June 15 (HealthDay News) -- Cystic fibrosis patients with methicillin-resistant staphylococcus aureus (MRSA) in their respiratory tract have worse survival rates than those without the drug-resistant bacteria, researchers have found.

The new study, published in the June 16 issue of the Journal of the American Medical Association, included 19,833 cystic fibrosis patients, aged 6 to 45, who were enrolled in the study from January 1996 to December 2006 and followed-up until December 2008. During the study period, 2,537 of the patients died and 5,759 had MRSA detected in their respiratory tract.

The death rate was 27.7 per 1,000 patient-years among those with MRSA and 18.3 deaths per 1,000 patient-years for those without MRSA. After adjusting for a number of factors, the researchers concluded that the risk of death was 1.3 times higher for patients with MRSA.

"These findings suggest that MRSA may be a potentially modifiable risk factor for death" in patients with cystic fibrosis, Dr. Elliott C. Dasenbrook, of Case Western Reserve University School of Medicine and University Hospitals Case Medical Center in Cleveland, and colleagues wrote in their report.

The new findings, along with previous data, suggest the need for more aggressive treatment of cystic fibrosis patients who are persistently MRSA-positive, Dasenbrook and colleagues pointed out, adding that the treatment should ideally be conducted in the context of clinical trials. They concluded that "the study results also reinforce the importance of following current [cystic fibrosis] infection-control guidelines to minimize transmission of MRSA," particularly in outpatient clinics with a high volume of cystic fibrosis patients.

Cystic fibrosis is a genetic, life-threatening disorder that causes severe lung damage and nutritional shortfalls. Among cystic fibrosis patients, the most common cause of death is respiratory failure secondary to lung infection. The prevalence of MRSA infection in the respiratory tract of cystic fibrosis patients has increased in recent years and is now more than 20%, according to background information provided in a news release from the journal's publisher.

-- Robert Preidt

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SOURCE: JAMA/Archives journals, news release, June 15, 2010