Air pollution exposure is associated with MRSA acquisition in young U.S. children with cystic fibrosis

• Published in: BMC pulmonary medicine Vol. 17; no. 1; pp. 106 - 9
• Main Authors: Psoter, Kevin J., De Roos, Anneclaire J., Wakefield, Jon, Mayer, Jonathan D., Rosenfeld, Margaret
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 27.07.2017; BioMed Central; BMC
• Subjects: Achromobacter denitrificans; Achromobacter xylosoxidans; Air Pollution; Birth weight; Care and treatment; Carrier State - epidemiology; Carrier State - microbiology; Child; Child, Preschool; Children; Children & youth; Clinical outcomes; Cohort Studies; Complications and side effects; Cystic fibrosis; Cystic Fibrosis - epidemiology; Cystic Fibrosis - microbiology; Diagnosis; Drug resistance; Environmental Exposure - statistics & numerical data; Female; Fine particulate matter; Gram-Negative Bacterial Infections - epidemiology; Gram-Negative Bacterial Infections - microbiology; Health aspects; Humans; Infant; Male; Methicillin; Methicillin-Resistant Staphylococcus aureus; MRSA; Multivariate Analysis; Particulate Matter; Pathogens; Population; Postal codes; Premature birth; Pulmonology; Regression Analysis; Respiratory tract diseases; Respiratory Tract Infections - epidemiology; Respiratory Tract Infections - microbiology; Retrospective Studies; Risk factors; Staphylococcal Infections - epidemiology; Staphylococcal Infections - microbiology; Staphylococcus aureus; Staphylococcus aureus infections; Staphylococcus infections; Stenotrophomonas maltophilia; United States; United States; United States > US; Stenotrophomonas maltophilia; Fine particulate matter; MRSA; Achromobacter xylosoxidans; Air pollution; Cystic fibrosis; Staphylococcus aureus
• ISSN: 1471-2466; 1471-2466
• DOI: 10.1186/s12890-017-0449-8

The role of air pollution in increasing susceptibility to respiratory tract infections in the cystic fibrosis (CF) population has not been well described. We recently demonstrated that chronic PM exposure is associated with an increased risk of initial Pseudomonas aeruginosa acquisition in young children with CF. The purpose of this study was to determine whether PM exposure is a risk factor for acquisition of other respiratory pathogens in young children with CF. We conducted a retrospective study of initial acquisition of methicillin susceptible and methicillin resistant Staphylococcus aureus (MSSA and MRSA), Stenotrophomonas maltophilia and Achromobacter xylosoxidans in U.S. children <6 years of age with CF using the CF Foundation Patient Registry, 2003-2009. Multivariable Weibull regression with interval-censored outcomes was used to evaluate the association of PM concentration in the year prior to birth and risk of acquisition of each organism. During follow-up 63%, 17%, 24%, and 5% of children acquired MSSA, MRSA, S. maltophilia, and A. xylosoxidans, respectively. A 10 μg/m increase in PM exposure was associated with a 68% increased risk of MRSA acquisition (Hazard Ratio: 1.68; 95% Confidence Interval: 1.24, 2.27). PM was not associated with acquisition of other respiratory pathogens. Fine particulate matter is an independent risk factor for initial MRSA acquisition in young children with CF. These results support the increasing evidence that air pollution contributes to pulmonary morbidities in the CF community.