1 Division of Pulmonary and Critical Care Medicine, University of Connecticut School of Medicine, Farmington, Connecticut.
2 Pulmonary Disease and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota.
Ann Am Thorac Soc. 2018 Mar;15(3):365-370. doi: 10.1513/AnnalsATS.201706-426OC.
Staphylococcus aureus is commonly cultured from the sputum of patients with bronchiectasis; however, little is known about the prevalence of the organism in these patients, the characteristics of patients who have grown the organism, or its implications.
Determine the relationship between S. aureus and pulmonary function, frequency of exacerbations, and frequency of hospitalization in patients with bronchiectasis Methods: The Bronchiectasis Research Registry is a database of adults with non-cystic fibrosis bronchiectasis identified from 13 sites within the United States. Baseline and follow-up demographic, spirometric, microbiologic, and therapeutic data were entered into a central web-based database. Patients were grouped into three cohorts based on their previous respiratory cultures at the time of entry into the Registry: 1) no prior S. aureus or glucose-nonfermenting gram-negative bacilli (NF-GNB) (Pseudomonas, Stenotrophomonas, or Burkholderia spp.); 2) prior S. aureus at least once; or 3) no prior S. aureus but prior NF-GNB at least once. The association between S. aureus isolation and pulmonary function and frequency of exacerbations and hospital admissions was assessed, both at baseline and after 1 year of follow-up.
S. aureus was cultured from 94 of 830 patients (11.3%) included in the analysis. Patients who had grown S. aureus before entry into the Registry had a frequency of prior exacerbations and baseline pulmonary function that was between that of patients who had grown NF-GNB and those who had grown neither NF-GNB or S. aureus. Similarly, at the first follow-up visit after study entry, patients who had grown S. aureus had a frequency of exacerbations and hospitalizations that was between those of patients who had grown NF-GNB and those who had grown neither NF-GNB nor S. aureus. However, in multivariate analysis, S. aureus was not associated with pulmonary function, frequency of exacerbation, or hospital admissions. There were no significant differences in patient characteristics or outcomes between patients who had methicillin-sensitive and methicillin-resistant S. aureus.
Staphylococcus aureus does not appear to be an independent risk factor for severe disease in patients with bronchiectasis enrolled in the Bronchiectasis Research Registry.
金黄色葡萄球菌通常从支气管扩张症患者的痰中培养出来；然而，对于金黄色葡萄球菌在这些患者中的流行程度、感染该菌的患者特征及其意义知之甚少。
确定金黄色葡萄球菌与支气管扩张症患者的肺功能、恶化频率和住院频率之间的关系。
支气管扩张症研究登记处是一个数据库，其中包含了来自美国 13 个地点的非囊性纤维化支气管扩张症成人患者。在登记处登记时，将基线和随访的人口统计学、肺活量测定、微生物学和治疗数据输入一个中央网络数据库。根据患者进入登记处前的呼吸道培养结果，将患者分为三组：1）无金黄色葡萄球菌或非发酵葡萄糖革兰氏阴性菌（假单胞菌、嗜麦芽窄食单胞菌或伯克霍尔德菌属）（Pseudomonas, Stenotrophomonas, or Burkholderia spp.）；2）至少有一次金黄色葡萄球菌；或 3）无金黄色葡萄球菌，但至少有一次非发酵葡萄糖革兰氏阴性菌。在基线和随访 1 年后，评估金黄色葡萄球菌分离株与肺功能以及恶化和住院的频率之间的关系。
在纳入分析的 830 名患者中，有 94 名（11.3%）培养出金黄色葡萄球菌。在进入登记处前培养出金黄色葡萄球菌的患者，其既往恶化频率和基线肺功能介于培养出非发酵葡萄糖革兰氏阴性菌的患者和未培养出非发酵葡萄糖革兰氏阴性菌和金黄色葡萄球菌的患者之间。同样，在研究入组后的第一次随访中，培养出金黄色葡萄球菌的患者，其恶化和住院的频率介于培养出非发酵葡萄糖革兰氏阴性菌的患者和未培养出非发酵葡萄糖革兰氏阴性菌和金黄色葡萄球菌的患者之间。然而，在多变量分析中，金黄色葡萄球菌与肺功能、恶化频率或住院无关。金黄色葡萄球菌敏感和耐药患者的患者特征和结局无显著差异。
金黄色葡萄球菌似乎不是支气管扩张症患者的严重疾病的独立危险因素。
