Impact of colonizing organism in the respiratory tract on the incidence, duration, and time between subsequent hospitalizations among patients with cystic fibrosis

• Published in: American journal of infection control 2019-07, Vol.47 (7), p.750-754
• Main Authors: Cios, Klaudia, Cohen, Bevin, Quittell, Lynne M., Liu, Jianfang, Larson, Elaine L.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Anti-Bacterial Agents - therapeutic use; Cross Infection - drug therapy; Cross Infection - microbiology; Cross Infection - mortality; Cross Infection - physiopathology; Cystic Fibrosis - drug therapy; Cystic Fibrosis - microbiology; Cystic Fibrosis - mortality; Cystic Fibrosis - physiopathology; Female; Hospital readmission; Humans; Incidence; Length of Stay - statistics & numerical data; Male; Methicillin-resistant Staphylococcus aureus; Methicillin-Resistant Staphylococcus aureus - drug effects; Methicillin-Resistant Staphylococcus aureus - growth & development; Methicillin-Resistant Staphylococcus aureus - pathogenicity; Methicillin-susceptible Staphylococcus aureus; Middle Aged; New York - epidemiology; Opportunistic Infections - drug therapy; Opportunistic Infections - microbiology; Opportunistic Infections - mortality; Opportunistic Infections - physiopathology; Patient Readmission - statistics & numerical data; Pseudomonas aeruginosa; Pseudomonas aeruginosa - drug effects; Pseudomonas aeruginosa - growth & development; Pseudomonas aeruginosa - pathogenicity; Pseudomonas Infections - drug therapy; Pseudomonas Infections - microbiology; Pseudomonas Infections - mortality; Pseudomonas Infections - physiopathology; Respiratory System - drug effects; Respiratory System - microbiology; Respiratory System - physiopathology; Retrospective Studies; Staphylococcal Infections - drug therapy; Staphylococcal Infections - microbiology; Staphylococcal Infections - mortality; Staphylococcal Infections - physiopathology
• ISSN: 0196-6553; 1527-3296
• DOI: 10.1016/j.ajic.2018.12.021

This study aimed to examine the association between colonizing respiratory tract organism and frequency, duration, and time between subsequent hospitalizations among hospitalized patients with cystic fibrosis (CF). This retrospective cohort study of 312 CF patients from 2 New York City hospitals (2006-2016) examined the effects of colonization with Pseudomonas aeruginosa, methicillin-susceptible Staphylococcus aureus (MSSA) or methicillin-resistant S aureus (MRSA), co-colonization on incidence of hospitalization, time to next hospitalization, and total length of stay (LOS). Annual rate of subsequent hospitalizations was highest in patients with P aeruginosa: adjusted incidence rate ratios (aIRRs) were 2.75 (95% confidence interval [CI], 1.72-4.41) for P aeruginosa versus MSSA, 2.57 (95% CI, 1.52-4.31) for co-colonization versus MSSA, and 1.77 (95% CI, 1.04-3.01) for P aeruginosa versus MRSA. Time to readmission was shortest for P aeruginosa: aIRRs were 1.75 (95% CI, 1.05-2.94) for MRSA versus P aeruginosa, 1.64 (95% CI, 1.03-2.59) for MSSA versus P aeruginosa, and 1.61 (95% CI, 1.04-2.47) for co-colonization versus P aeruginosa. LOS was longest for P aeruginosa: aIRRs were 3.41 (95% CI, 2.19-5.32) for P aeruginosa versus MSSA, 1.66 (95% CI, 1.01-2.75) for co-colonization versus MSSA, 2.50 (95% CI, 1.58-3.93) for P aeruginosa versus MRSA, and 2.05 (95% CI, 1.32-3.18) for P aeruginosa versus co-colonization. CF patients with P aeruginosa alone experienced more hospitalizations, longer LOS, and shorter time to readmission versus patients with S aureus or both organisms.