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J Cyst Fibros. 2013 Sep;12(5):497-503. doi: 10.1016/j.jcf.2012.12.003. Epub 2013 Jan 3.

Association between Staphylococcus aureus alone or combined with Pseudomonas aeruginosa and the clinical condition of patients with cystic fibrosis.

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Service de Pneumologie, Hôpital Cochin, AP-HP, Paris, France.



The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in cystic fibrosis (CF) patients has increased and MRSA seems to be associated with a poorer prognosis. The aim of this study was to assess the prevalence and clinical consequences of MRSA and methicillin-susceptible Staphylococcus aureus (MSSA), associated or not associated with Pseudomonas aeruginosa (PA).


In a retrospective study on 419 sputum producer patients (293 adults and 126 children >7 years of age), we recorded patient characteristics, lung function, nutritional status, i.v. antibiotics and hospitalisations, the presence of SA and/or PA and FEV1 decline over 2 years.


SA was found in 72% of the patients: MSSA in 68.2% of children and 48.8% of adults; MRSA in 17.5% of children and 17.8% of adults. Sixty percent of MRSA patients and 60.4% of MSSA patients also harboured PA. The rate of deterioration of clinical status of the various groups, as assessed from respiratory function, i.v. antibiotic courses and hospitalisations, increased in the order: no SA/no PA, MSSA alone, MRSA alone, MSSA/PA, MRSA/PA, and PA alone. Nutritional status did not differ between groups. Results were roughly similar for children and adults. The yearly FEV1 decline was significantly higher only for MRSA/PA patients (p=0.03) compared to no SA/no PA patients.


Clinical condition of CF patients with MSSA only or MRSA only appeared similar, whereas MRSA/PA patients had more severe respiratory function than MSSA/PA patients. In CF patients, MRSA might be more deleterious than MSSA only when associated with PA.


Cystic fibrosis; Lung function; MRSA; Pseudomonas aeruginosa; Staphylococcus aureus

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