{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T06:00:37Z","timestamp":1789365637291,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,6,14]],"date-time":"2013-06-14T00:00:00Z","timestamp":1371168000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006501","name":"Cystic Fibrosis Foundation Therapeutics","doi-asserted-by":"crossref","award":["MUHLEB08A0"],"award-info":[{"award-number":["MUHLEB08A0"]}],"id":[{"id":"10.13039\/100006501","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      The prevalence of methicillin\u2010resistant\n                      <jats:italic>Staphylococcus aureus<\/jats:italic>\n                      (MRSA) in cystic fibrosis (CF) patients in the United States is approximately 25%. Little is known about the relative proportion of hospital\u2010 versus community\u2010associated strains or the antimicrobial susceptibility of MRSA in different CF centers. We hypothesized that the majority of MRSA isolates obtained from children with CF are those endemic in the hospital and that those associated with community acquisition (SCC\n                      <jats:italic>mec<\/jats:italic>\n                      IV) would be more resistant than typically seen in non\u2010CF MRSA isolates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We studied MRSA strains from seven pediatric CF centers to determine the clonal distribution based on DNA sequencing of the staphylococcal protein A gene (\n                      <jats:italic>spa<\/jats:italic>\n                      typing), the type of staphylococcal chromosomal cassette\n                      <jats:italic>mec<\/jats:italic>\n                      (SCC\n                      <jats:italic>mec<\/jats:italic>\n                      ), and the proportion of strains with Panton\u2010Valentine leukocidin (PVL). Antimicrobial susceptibility to systemic and topical antibiotics was compared between different MRSA types.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We analyzed 277 MRSA isolates from unique patients (mean age 11.15\u2009\u00b1\u20094.77 years, 55% male). Seventy % of isolates were SCC\n                      <jats:italic>mec<\/jats:italic>\n                      II PVL negative and the remainder SCC\n                      <jats:italic>mec<\/jats:italic>\n                      IV. Overall 17% MRSA strains were PVL positive (all SCC\n                      <jats:italic>mec<\/jats:italic>\n                      IV).\n                      <jats:italic>Spa<\/jats:italic>\n                      typing of 118 isolates showed most of the SCC\n                      <jats:italic>mec<\/jats:italic>\n                      II strains being t002, while SCC\n                      <jats:italic>mec<\/jats:italic>\n                      IV PVL positive isolates were t008, and SCC\n                      <jats:italic>mec<\/jats:italic>\n                      IV PVL negative isolates represented a variety of\n                      <jats:italic>spa<\/jats:italic>\n                      \u2010types. The proportions of SCC\n                      <jats:italic>mec<\/jats:italic>\n                      II strains and\n                      <jats:italic>spa<\/jats:italic>\n                      \u2010types were similar among centers. Overall rates of resistance to trimethoprim\u2013sulfamethoxazole (4%), tetracycline (7%), tigecycline (0.4%), linezolid (0.4%) as well as fosfomycin (0.4%), fusidic acid (3%), and mupirocin (1%) were low. No strains were resistant to vancomycin. SCC\n                      <jats:italic>mec<\/jats:italic>\n                      II strains had higher rates of resistance to ciprofloxacin and clindamycin (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) than SCC\n                      <jats:italic>mec<\/jats:italic>\n                      IV strains.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      In this U.S. study, most MRSA isolates in the pediatric CF population were SCC\n                      <jats:italic>mec<\/jats:italic>\n                      II PVL negative. Rates of resistance were low, including to older and orally available antibiotics such as trimethoprim\u2013sulfamethoxazole.\n                      <jats:bold>Pediatr Pulmonol. 2014; 49:230\u2013237.<\/jats:bold>\n                      \u00a9 2013 Wiley Periodicals, Inc.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.22815","type":"journal-article","created":{"date-parts":[[2013,6,14]],"date-time":"2013-06-14T06:14:57Z","timestamp":1371190497000},"page":"230-237","source":"Crossref","is-referenced-by-count":45,"title":["Antimicrobial susceptibility and molecular typing of MRSA in cystic fibrosis"],"prefix":"10.1002","volume":"49","author":[{"given":"E.A.","family":"Champion","sequence":"first","affiliation":[{"name":"Division of Pediatric Pulmonology, Department of Pediatrics University of North Carolina Chapel Hill North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.B.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine School of Medicine, University of North Carolina Chapel Hill North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.B.","family":"Popowitch","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine School of Medicine, University of North Carolina Chapel Hill North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.M.","family":"Hobbs","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Microbiology &amp; Immunology University of North Carolina Chapel Hill North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Saiman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Columbia University Medical Center New York New York"},{"name":"Department of Infection Prevention and Control New York\u2010Presbyterian Hospital New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.S.","family":"Muhlebach","sequence":"additional","affiliation":[{"name":"Division of Pediatric Pulmonology, Department of Pediatrics University of North Carolina Chapel Hill North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the STAR\u2010CF Study Team","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,6,14]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.2006.01744.x"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1526-0542(04)90065-6"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2006.01.004"},{"key":"e_1_2_6_5_1","unstructured":"CF Foundation.Cystic Fibrosis Patient Registry. 2010 2012."},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.20604"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.06-2756"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.20774"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.791"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200802-327OC"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00480-08"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.40.11.4289-4294.2002"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1086\/345436"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1086\/533502"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.37.11.3556-3563.1999"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2010.09.010"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02402-06"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1086\/503485"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2007.01720.x"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbrc.2005.01.054"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00255-09"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.2174\/156652409787581637"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.41.12.5442-5448.2003"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf.2011.06.005"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf.2011.02.004"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.07-2437"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1086\/533591"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-2300"},{"key":"e_1_2_6_29_1","volume-title":"Use of an inferred PFGE algorithm, emerging infections program\/active bacterial core (ABCs) surveillance invasive MRSA project. 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