Division of Pediatric Pulmonology, Department of Pediatrics, University of California, 550 16th Ave, Box 0632, San Francisco, CA 94158, United States.
Department of Epidemiology and Biostatistics, University of California, San Francisco, United States.
J Cyst Fibros. 2023 Sep;22(5):909-915. doi: 10.1016/j.jcf.2023.07.004. Epub 2023 Jul 16.
Hispanic people with CF (pwCF) have increased morbidity than non-Hispanic White pwCF, including increased risk of Pseudomonas aeruginosa. We aimed to determine if Staphylococcus aureus (S. aureus) acquisition varies between Hispanic and non-Hispanic White pwCF.
This longitudinal cohort study of pwCF ages 0-25 years in the CF Foundation Patient Registry compared acquisition of methicillin-sensitive S. aureus (MSSA), methicillin-resistant S. aureus (MRSA), persistent MRSA between Hispanic and non-Hispanic White pwCF. Risk of acquisition was assessed by Kaplan-Meier survival curves and its association with ethnicity was evaluated using Cox regressions. Adjusted associations were evaluated using multivariate Cox models adjusting for sex, age of entry into CFFPR, CFTR variant severity, pancreatic insufficiency, CF-related diabetes, maternal education, insurance status.
Of 10,640 pwCF, 7.5% were Hispanic and 92.5% were non-Hispanic White. Hispanic pwCF had a 19% higher risk of acquiring MSSA (HR 1.19, 95% CI 1.10-1.28, p<0.001) and 13% higher risk of acquiring MRSA (HR 1.13, 95% CI 1.02-1.26, p = 0.02) than non-Hispanic White pwCF. The difference in persistent MRSA between ethnicities did not reach statistical significance. After adjusting for confounding variables, only the risk of MSSA was significantly associated with ethnicity. Compared to non-Hispanic White pwCF, Hispanic pwCF acquired MSSA and MRSA at younger median ages (4.9 vs. 3.8 years (p<0.001), 22.4 vs. 20.8 years (p = 0.02).
Hispanic pwCF <25 years of age have an increased risk of acquiring MSSA and acquired MSSA and MRSA at an earlier age. Differences in S. aureus acquisition may contribute to increased morbidity in Hispanic pwCF.
患有 CF（囊性纤维化）的西班牙裔患者比非西班牙裔白种人患者的发病率更高，包括铜绿假单胞菌感染的风险增加。我们旨在确定西班牙裔和非西班牙裔白种人 CF 患者之间金黄色葡萄球菌（金黄色葡萄球菌）的获得是否存在差异。
这项 CF 基金会患者登记处的 CF 患者年龄在 0-25 岁的纵向队列研究比较了耐甲氧西林金黄色葡萄球菌（MSSA）、耐甲氧西林金黄色葡萄球菌（MRSA）、MSSA 在西班牙裔和非西班牙裔白种人 CF 患者中的获得情况。使用 Kaplan-Meier 生存曲线评估获得的风险，并使用 Cox 回归评估其与种族的关联。使用多变量 Cox 模型调整性别、进入 CFFPR 时的年龄、CFTR 变体严重程度、胰腺功能不全、CF 相关糖尿病、母亲教育程度、保险状况后，评估调整后的关联。
在 10640 名 CF 患者中，7.5%为西班牙裔，92.5%为非西班牙裔白种人。与非西班牙裔白种人 CF 患者相比，西班牙裔 CF 患者获得 MSSA 的风险高 19%（HR 1.19，95%CI 1.10-1.28，p<0.001），获得 MRSA 的风险高 13%（HR 1.13，95%CI 1.02-1.26，p=0.02）。种族之间持续 MRSA 的差异没有统计学意义。在调整混杂变量后，只有 MSSA 的风险与种族显著相关。与非西班牙裔白种人 CF 患者相比，西班牙裔 CF 患者在更年轻的中位年龄时获得 MSSA 和 MRSA（4.9 岁与 3.8 岁（p<0.001），22.4 岁与 20.8 岁（p=0.02）。
25 岁以下的西班牙裔 CF 患者感染 MSSA 的风险增加，并且更早地获得 MSSA 和 MRSA。金黄色葡萄球菌获得的差异可能导致西班牙裔 CF 患者发病率增加。
