The impact of methicillin-resistant Staphylococcus aureus colonisation on paediatric cystic fibrosis patients morbidity [Colonização por Staphylococcus aureus resistente à meticilina: Que impacto na morbilidade de doentes pediátricos com fibrose quística?]

Background: methicillin-resistant staphylococcus aureus (mrsa) plays a well-recognised pathogenic role in cystic fibrosis (cf). aims: to evaluate the prevalence and incidence of colonisation by mrsa,clinical impact of mrsa colonisation (year after first mrsa isolation),risk factors and pattern of antimicrobial resistance. methods: retrospective review of paediatric cf patients colonised with mrsa followed-up at the cf unit of hospital de santa maria 2003-2007. results: twelve of the 60 patients followed-up during this period were mrsa-positive at some time (chronic colonisation in 3 patients). mean age at acquisition was 9 years 10 months and mean time interval between cf diagnosis and mrsa acquisition 5 years 7 months. an important rise in mrsa colonisation prevalence and incidence was observed,with the highest rate seen in 2007 (prevalence 14.3% and incidence 8.9%). four patients had received anti-staphylococcal prophylaxis with flucloxacillin. an increase in the total number of in-patient days was observed in four patients (two with chronic colonisation). deterioration in lung function was seen in five patients (including the three patients with chronic colonisation). only one patient had a decrease in body mass index percentile. resistance to clindamycin and rifampin was the most frequently seen. conclusions: this study revealed significant clinical deterioration in patients with chronic colonisation by mrsa,reinforcing the importance of effective and timely decolonisation strategies.