METHODS
The aim of this study was to develop a CFA at a single pediatric CF care
center, Children’s Mercy Kansas City (CMKC). IRB approval was obtained
at CMKC. Data from all respiratory isolates from individuals with a
diagnosis of CF obtained between 01 January 2015 and 31 December 2019 at
CMKC were reviewed for study inclusion. Demographic information
collected included the sex and age of the patient. Culture source was
coded as sputum or oropharyngeal swab and were differentiated through a
microbiology report. The microorganisms included in analysis for the CFA
included: methicillin-susceptible Staphylococcus aureus (MSSA),
methicillin-resistant Staphylococcus aureus (MRSA),Pseudomonas aeruginosa (PA), Achromobacter species,Stenotrophomonas maltophila , and Burkholderia cepaciacomplex including Burkholderia multivorans, B. cenocepacia, B.
gladioloi , and B. vietnamiensis species. Per CLSI guidelines,
only species with a minimum of 30 isolates during the study period were
included in the CFA.11 No other isolates were
included. Antimicrobial susceptibility information was collected for all
CF isolates. Each culture represents a distinct patient encounter. For
people with CF with multiple isolates growing the same microorganism
during the same year, only the first chronological isolate was included
in the antibiogram. This methodology was based on CLSI guidance for
handling multiple isolates within the same year.11
The CF antibiogram was compared to the HWA each year. The HWA is an
annual compilation of system-wide susceptibility results from cultures
from all sources. These HWA are published in June of each year. Cultures
from people with CF are excluded from the HWA.
Descriptive statistics included mean and percentages. Additional
statistical analyses of antibiogram data and susceptibility information
were performed using X2 or Fisher’s exact test for
categorical data, as appropriate, and t-test for non-categorical data.
All tests of significance were two-tailed and p -values of ≤0.05
were considered statistically significant.