dc.contributor.author
Junge, Sibylle
dc.contributor.author
Görlich, Dennis
dc.contributor.author
Reijer, Martijn den
dc.contributor.author
Wiedemann, Bärbel
dc.contributor.author
Tümmler, Burkhard
dc.contributor.author
Ellemunter, Helmut
dc.contributor.author
Staab, Doris [u.v.m.]
dc.date.accessioned
2018-06-08T10:53:26Z
dc.date.available
2017-01-13T13:13:15.675Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/21282
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-24577
dc.description.abstract
Background Staphylococcus aureus is an important pathogen in cystic fibrosis
(CF). However, it is not clear which factors are associated with worse lung
function in patients with persistent S. aureus airway cultures. Our main
hypothesis was that patients with high S. aureus density in their respiratory
specimens would more likely experience worsening of their lung disease than
patients with low bacterial loads. Methods Therefore, we conducted an
observational prospective longitudinal multi-center study and assessed the
association between lung function and S. aureus bacterial density in
respiratory samples, co-infection with other CF-pathogens, nasal S. aureus
carriage, clinical status, antibiotic therapy, IL-6- and IgG-levels against S.
aureus virulence factors. Results 195 patients from 17 centers were followed;
each patient had an average of 7 visits. Data were analyzed using descriptive
statistics and generalized linear mixed models. Our main hypothesis was only
supported for patients providing throat specimens indicating that patients
with higher density experienced a steeper lung function decline (p<0.001).
Patients with exacerbations (n = 60), S. aureus small-colony variants (SCVs, n
= 84) and co-infection with Stenotrophomonas maltophilia (n = 44) had worse
lung function (p = 0.0068; p = 0.0011; p = 0.0103). Patients with SCVs were
older (p = 0.0066) and more often treated with trimethoprim/sulfamethoxazole
(p = 0.0078). IL-6 levels positively correlated with decreased lung function
(p<0.001), S. aureus density in sputa (p = 0.0016), SCVs (p = 0.0209),
exacerbations (p = 0.0041) and co-infections with S. maltophilia (p = 0.0195)
or A. fumigatus (p = 0.0496). Conclusions In CF-patients with chronic S.
aureus cultures, independent risk factors for worse lung function are high
bacterial density in throat cultures, exacerbations, elevated IL-6 levels,
presence of S. aureus SCVs and co-infection with S. maltophilia. Trial
Registration ClinicalTrials.gov NCT00669760
en
dc.rights.uri
http://creativecommons.org/licenses/by/4.0/
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit
dc.title
Factors Associated with Worse Lung Function in Cystic Fibrosis Patients with
Persistent Staphylococcus aureus
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation
PLoS ONE. - 11 (2016), 11, Artikel Nr. e0166220
dcterms.bibliographicCitation.doi
10.1371/journal.pone.0166220
dcterms.bibliographicCitation.url
http://dx.doi.org/10.1371/journal.pone.0166220
refubium.affiliation
Charité - Universitätsmedizin Berlin
de
refubium.mycore.fudocsId
FUDOCS_document_000000026144
refubium.note.author
Der Artikel wurde in einer reinen Open-Access-Zeitschrift.
refubium.resourceType.isindependentpub
no
refubium.mycore.derivateId
FUDOCS_derivate_000000007529
dcterms.accessRights.openaire
open access