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        "titulo" => "Resumo"
        "resumen" => "<span id="as0005" class="elsevierStyleSection elsevierViewall"><p id="sp0005" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Introdu&#231;&#227;o&#58;</span> Ao <span class="elsevierStyleItalic">Staphylococcus aureus</span> resistente &#224; meticilina &#40;MRSA&#41; &#233; classicamente reconhecido um papel patog&#233;nico no &#226;mbito da fibrose qu&#237;stica &#40;FQ&#41;&#46;</p><p id="sp0010" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Objectivos&#58;</span> Avalia&#231;&#227;o da evolu&#231;&#227;o da preval&#234;ncia e incid&#234;ncia da coloniza&#231;&#227;o por MRSA&#44; impacto cl&#237;nico no ano ap&#243;s o primeiro isolamento&#44; factores de risco e padr&#227;o de resist&#234;ncia antimicrobiana&#46;</p><p id="sp0015" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">M&#233;todos&#58;</span> Estudo retrospectivo dos doentes pedi&#225;tricos colonizados por MRSA seguidos no centro de FQ do Hospital de Santa Maria de 2003 a 2007&#46;</p><p id="sp0020" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Resultados&#58;</span> O MRSA foi isolado em secre&#231;&#245;es respirat&#243;rias de 12 dos 60 doentes seguidos durante este per&#237;odo &#40;coloniza&#231;&#227;o cr&#243;nica em 3 doentes&#41;&#46; A idade m&#233;dia &#224; data do primeiro isolamento foi de 9 anos e 10 meses e o tempo m&#233;dio entre o diagn&#243;stico de FQ e a aquisi&#231;&#227;o de MRSA de 5 anos e 7 meses&#46;</p><p id="sp0025" class="elsevierStyleSimplePara elsevierViewall">Verificou-se um aumento da preval&#234;ncia e incid&#234;ncia de coloniza&#231;&#227;o por MRSA&#44; com um m&#225;ximo atingido em 2007 &#40;preval&#234;ncia 14&#44;3&#37; e incid&#234;ncia 8&#44;9&#37;&#41;&#46; Quatro doentes cumpriram antibioticoterapia profil&#225;ctica antiestafiloc&#243;cica com flucloxacilina&#46;</p><p id="sp0030" class="elsevierStyleSimplePara elsevierViewall">No ano ap&#243;s o primeiro isolamento de MRSA&#44; constatou-se um aumento do n&#250;mero de dias de internamento em 4 doentes &#40;2 com coloniza&#231;&#227;o cr&#243;nica&#41; e deteriora&#231;&#227;o da fun&#231;&#227;o pulmonar em 5&#44; incluindo a totalidade dos doentes com coloniza&#231;&#227;o cr&#243;nica&#46; Apenas um doente apresentou diminui&#231;&#227;o de percentil de &#237;ndice de massa corporal&#46;</p><p id="sp0035" class="elsevierStyleSimplePara elsevierViewall">As resist&#234;ncias mais frequentemente encontradas foram &#224; rifampicina e &#224; clindamicina&#46;</p><p id="sp0040" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Conclus&#245;es&#58;</span> Este estudo revelou ocorr&#234;ncia de deteriora&#231;&#227;o cl&#237;nica relevante em doentes com coloniza&#231;&#227;o cr&#243;nica por MRSA&#44; refor&#231;ando a import&#226;ncia da implementa&#231;&#227;o de estrat&#233;gias eficazes e precoces de erradica&#231;&#227;o&#46;</p><p id="sp0045" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2010&#59; XVI &#40;4&#41;&#58; 527-542</span></p></span>"
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        "titulo" => "Abstract"
        "resumen" => "<span id="as0010" class="elsevierStyleSection elsevierViewall"><p id="sp0050" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Background&#58;</span> Methicillin-resistant <span class="elsevierStyleItalic">Staphylococcus aureus</span> &#40;MRSA&#41; plays a well-recognised pathogenic role in cystic fibrosis &#40;CF&#41;&#46;</p><p id="sp0055" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Aims&#58;</span> To evaluate the prevalence and incidence of colonisation by MRSA&#44; clinical impact of MRSA colonisation &#40;year after first MRSA isolation&#41;&#44; risk factors and pattern of antimicrobial resistance&#46;</p><p id="sp0060" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Methods&#58;</span> Retrospective review of paediatric CF patients colonised with MRSA followed-up at the CF Unit of Hospital de Santa Maria 2003-2007&#46;</p><p id="sp0065" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Results&#58;</span> Twelve of the 60 patients followed-up during this period were MRSA-positive at some time &#40;chronic colonisation in 3 patients&#41;&#46; Mean age at acquisition was 9 years 10 months and mean time interval between CF diagnosis and MRSA acquisition 5 years 7 months&#46;</p><p id="sp0070" class="elsevierStyleSimplePara elsevierViewall">An important rise in MRSA colonisation prevalence and incidence was observed&#44; with the highest rate seen in 2007 &#40;prevalence 14&#46;3&#37; and incidence 8&#46;9&#37;&#41;&#46;</p><p id="sp0075" class="elsevierStyleSimplePara elsevierViewall">Four patients had received anti-staphylococcal prophylaxis with flucloxacillin&#46;</p><p id="sp0080" class="elsevierStyleSimplePara elsevierViewall">An increase in the total number of in-patient days was observed in four patients &#40;two with chronic colonisation&#41;&#46; Deterioration in lung function was seen in five patients &#40;including the three patients with chronic colonisation&#41;&#46; Only one patient had a decrease in body mass index percentile&#46; Resistance to clindamycin and rifampin was the most frequently seen&#46;</p><p id="sp0085" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Conclusions&#58;</span> This study revealed significant clinical deterioration in patients with chronic colonisation by MRSA&#44; reinforcing the importance of effective and timely decolonisation strategies&#46;</p><p id="sp0090" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2010&#59; XVI &#40;4&#41;&#58; 527-542</span></p></span>"
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Artigo Original/Original Article
Colonização por Staphylococcus aureus resistente à meticilina: Que impacto na morbilidade de doentes pediátricos com fibrose quística?
The impact of methicillin-resistant Staphylococcus aureus colonisation on paediatric cystic fibrosis patients’ morbidity
Joana Fermeiro1,
Corresponding author
jsnfermeiro@hotmail.com

Correspondência/Correspondence to: Departamento da Criança e da Família do Hospital de Santa Maria, Avenida Professor Egas Moniz, 1649-035 Lisboa
, Patrícia Reis1, Susana Castanhinha1, Luísa Pereira2, Celeste Barreto3
1 Interna do Internato Complementar de Pediatria/Resident, Paediatrics
2 Assistente Hospitalar Graduada de Pediatria/Consultant, Paediatrics specialist
3 Chefe de Serviço de Pediatria/Head, Paediatrics Unit
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            "correspondencia" => "<span class="elsevierStyleBold">Correspond&#234;ncia&#47;<span class="elsevierStyleItalic">Correspondence to&#58;</span></span> Departamento da Crian&#231;a e da Fam&#237;lia do Hospital de Santa Maria&#44; Avenida Professor Egas Moniz&#44; 1649-035 Lisboa"
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    "titulosAlternativos" => array:1 [
      "en" => array:1 [
        "titulo" => "The impact of methicillin-resistant Staphylococcus aureus colonisation on paediatric cystic fibrosis patients&#8217; morbidity"
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    "fechaRecibido" => "2009-07-13"
    "fechaAceptado" => "2010-01-07"
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          "palabras" => array:3 [
            0 => "Fibrose qu&#237;stica"
            1 => "MRSA"
            2 => "erradica&#231;&#227;o"
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        0 => array:4 [
          "clase" => "keyword"
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            0 => "Cystic fibrosis"
            1 => "MRSA"
            2 => "decolonisation"
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    "resumen" => array:2 [
      "pt" => array:2 [
        "titulo" => "Resumo"
        "resumen" => "<span id="as0005" class="elsevierStyleSection elsevierViewall"><p id="sp0005" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Introdu&#231;&#227;o&#58;</span> Ao <span class="elsevierStyleItalic">Staphylococcus aureus</span> resistente &#224; meticilina &#40;MRSA&#41; &#233; classicamente reconhecido um papel patog&#233;nico no &#226;mbito da fibrose qu&#237;stica &#40;FQ&#41;&#46;</p><p id="sp0010" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Objectivos&#58;</span> Avalia&#231;&#227;o da evolu&#231;&#227;o da preval&#234;ncia e incid&#234;ncia da coloniza&#231;&#227;o por MRSA&#44; impacto cl&#237;nico no ano ap&#243;s o primeiro isolamento&#44; factores de risco e padr&#227;o de resist&#234;ncia antimicrobiana&#46;</p><p id="sp0015" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">M&#233;todos&#58;</span> Estudo retrospectivo dos doentes pedi&#225;tricos colonizados por MRSA seguidos no centro de FQ do Hospital de Santa Maria de 2003 a 2007&#46;</p><p id="sp0020" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Resultados&#58;</span> O MRSA foi isolado em secre&#231;&#245;es respirat&#243;rias de 12 dos 60 doentes seguidos durante este per&#237;odo &#40;coloniza&#231;&#227;o cr&#243;nica em 3 doentes&#41;&#46; A idade m&#233;dia &#224; data do primeiro isolamento foi de 9 anos e 10 meses e o tempo m&#233;dio entre o diagn&#243;stico de FQ e a aquisi&#231;&#227;o de MRSA de 5 anos e 7 meses&#46;</p><p id="sp0025" class="elsevierStyleSimplePara elsevierViewall">Verificou-se um aumento da preval&#234;ncia e incid&#234;ncia de coloniza&#231;&#227;o por MRSA&#44; com um m&#225;ximo atingido em 2007 &#40;preval&#234;ncia 14&#44;3&#37; e incid&#234;ncia 8&#44;9&#37;&#41;&#46; Quatro doentes cumpriram antibioticoterapia profil&#225;ctica antiestafiloc&#243;cica com flucloxacilina&#46;</p><p id="sp0030" class="elsevierStyleSimplePara elsevierViewall">No ano ap&#243;s o primeiro isolamento de MRSA&#44; constatou-se um aumento do n&#250;mero de dias de internamento em 4 doentes &#40;2 com coloniza&#231;&#227;o cr&#243;nica&#41; e deteriora&#231;&#227;o da fun&#231;&#227;o pulmonar em 5&#44; incluindo a totalidade dos doentes com coloniza&#231;&#227;o cr&#243;nica&#46; Apenas um doente apresentou diminui&#231;&#227;o de percentil de &#237;ndice de massa corporal&#46;</p><p id="sp0035" class="elsevierStyleSimplePara elsevierViewall">As resist&#234;ncias mais frequentemente encontradas foram &#224; rifampicina e &#224; clindamicina&#46;</p><p id="sp0040" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Conclus&#245;es&#58;</span> Este estudo revelou ocorr&#234;ncia de deteriora&#231;&#227;o cl&#237;nica relevante em doentes com coloniza&#231;&#227;o cr&#243;nica por MRSA&#44; refor&#231;ando a import&#226;ncia da implementa&#231;&#227;o de estrat&#233;gias eficazes e precoces de erradica&#231;&#227;o&#46;</p><p id="sp0045" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2010&#59; XVI &#40;4&#41;&#58; 527-542</span></p></span>"
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      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span id="as0010" class="elsevierStyleSection elsevierViewall"><p id="sp0050" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Background&#58;</span> Methicillin-resistant <span class="elsevierStyleItalic">Staphylococcus aureus</span> &#40;MRSA&#41; plays a well-recognised pathogenic role in cystic fibrosis &#40;CF&#41;&#46;</p><p id="sp0055" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Aims&#58;</span> To evaluate the prevalence and incidence of colonisation by MRSA&#44; clinical impact of MRSA colonisation &#40;year after first MRSA isolation&#41;&#44; risk factors and pattern of antimicrobial resistance&#46;</p><p id="sp0060" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Methods&#58;</span> Retrospective review of paediatric CF patients colonised with MRSA followed-up at the CF Unit of Hospital de Santa Maria 2003-2007&#46;</p><p id="sp0065" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Results&#58;</span> Twelve of the 60 patients followed-up during this period were MRSA-positive at some time &#40;chronic colonisation in 3 patients&#41;&#46; Mean age at acquisition was 9 years 10 months and mean time interval between CF diagnosis and MRSA acquisition 5 years 7 months&#46;</p><p id="sp0070" class="elsevierStyleSimplePara elsevierViewall">An important rise in MRSA colonisation prevalence and incidence was observed&#44; with the highest rate seen in 2007 &#40;prevalence 14&#46;3&#37; and incidence 8&#46;9&#37;&#41;&#46;</p><p id="sp0075" class="elsevierStyleSimplePara elsevierViewall">Four patients had received anti-staphylococcal prophylaxis with flucloxacillin&#46;</p><p id="sp0080" class="elsevierStyleSimplePara elsevierViewall">An increase in the total number of in-patient days was observed in four patients &#40;two with chronic colonisation&#41;&#46; Deterioration in lung function was seen in five patients &#40;including the three patients with chronic colonisation&#41;&#46; Only one patient had a decrease in body mass index percentile&#46; Resistance to clindamycin and rifampin was the most frequently seen&#46;</p><p id="sp0085" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Conclusions&#58;</span> This study revealed significant clinical deterioration in patients with chronic colonisation by MRSA&#44; reinforcing the importance of effective and timely decolonisation strategies&#46;</p><p id="sp0090" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2010&#59; XVI &#40;4&#41;&#58; 527-542</span></p></span>"
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Article information
ISSN: 08732159
Original language: Portuguese
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