ABSTRACT
BACKGROUND: Bordetella bronchiseptica is a common pathogenic or colonizing organism of domestic mammals. In dogs, it causes an infectious tracheobronchitis known as Kennel Cough. Human infections are unusual and almost exclusively described in immunocompromised patients who have had contact with a known animal reservoir. It is rarely reported in Cystic Fibrosis (CF), possibly hampered by low recovery from culture and organism misidentification. We describe the incidence and characteristics of B. bronchiseptica in our CF population. METHODS: A retrospective cohort study was conducted of our center's CF patient population. Patients were included if they had B. bronchiseptica isolated on one or more occasion. RESULTS: Seven children with CF isolated B. bronchiseptica on 23 occasions, frequently associated with the symptoms of a pulmonary exacerbation. Four patients required hospitalization. CONCLUSION: These results suggest that B. bronchiseptica may be more common than previously reported and may play a potential pathogenic role in CF.
Subject(s)
Bordetella Infections/diagnosis , Bordetella bronchiseptica/isolation & purification , Cystic Fibrosis/microbiology , Immunocompromised Host , Respiratory Tract Infections/microbiology , Adolescent , Animals , Anti-Bacterial Agents/therapeutic use , Bordetella Infections/drug therapy , Bordetella Infections/epidemiology , Bordetella bronchiseptica/immunology , Child , Child, Preschool , Cystic Fibrosis/epidemiology , Cystic Fibrosis/immunology , Dog Diseases/epidemiology , Dog Diseases/microbiology , Dogs , Female , Humans , Incidence , Infant , Male , Respiratory Tract Infections/drug therapy , Respiratory Tract Infections/epidemiology , Retrospective Studies , Treatment Outcome , Young AdultABSTRACT
BACKGROUND: The emergence and epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) at a Minneapolis pediatric healthcare facility was investigated. METHODS: Children with MRSA infections from January 1991 to December 2003 were classified as community-associated (CA) or healthcare-associated (HA) using established criteria. Isolates were subtyped using pulsed-field gel electrophoresis and grouped into pulsed-field types (PFTs). Case and isolate characteristics were compared and temporal trends were assessed. RESULTS: The first isolate classified as CA-MRSA in this healthcare facility was identified in 1991. CA-MRSA cases (n = 188) were more likely than HA-MRSA cases (n = 83) to have a skin or soft tissue infection (80% versus 59%) and to belong to a racial or ethnic minority group (82% versus 55%), whereas HA-MRSA cases were younger (median age, 3.4 years versus 4.9 years). The proportion of both CA- and HA-MRSA isolates susceptible to clindamycin and erythromycin declined during the study period. Isolates classified as CA-MRSA were more likely than HA-MRSA isolates to be USA300 (21% versus 11%, P = 0.05) and USA400 (62% versus 31%, P < 0.001) PFTs. Associations between case race/ethnicity and isolate PFT were observed independent of case classification. CONCLUSIONS: CA-MRSA is well established in this pediatric population. Although no discernable changes in CA- or HA-MRSA case characteristics were documented during the study period, significant changes were observed in CA-MRSA isolate characteristics, indicating that this pathogen continues to evolve.
