Antibiotic Treatment and Age Are Associated With Staphylococcus aureus Carriage Profiles During Persistence in the Airways of Cystic Fibrosis Patients
ConclusionThere was a significant association of antibiotic therapy and age on S. aureus carriage profiles in CF patients indicating that antibiotic therapy prevents acquisition of new clones, while during aging of patients with persisting S. aureus, dominant clones were selected and mutations in the spa-repeat region accumulated.
Cystic Fibrosis (CF) is a condition known to have chronic infection of the airways with persistent and excessive inflammation, and abnormally thickened airway secretions leading to bronchiectasis . Persons with CF are preferentially susceptible to certain chronic pathogens such as methicillin resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa, Burkholderia cepacia, Stenotrophomonas maltophilia among others [2 –5]. Nontuberculous mycobacteria (NTM) species have recently risen in significance because of recognition of increased prevalence and perceived pathogenicity [6–10].
In conclusion, AeroVanc was well tolerated and achieved high levels in sputum with a mean systemic absorption of 49%, making it a potential therapeutic strategy for respiratory infection with MRSA. PMID: 31964790 [PubMed - as supplied by publisher]
This study investigated the impact of a short-term transfer program on clinical markers in an adult CF cohort still being managed by pediatricians. Methods: Clinically relevant data from the year before (T-1), the time of Transfer (T) and the year after the transfer (T+1) were analysed retrospectively. Results: 39 patients (median age 29.0 years; 64% male) were transferred between February and December 2016. Lung function had declined significantly in the year before transfer (in % predicted: Forced Expiratory Volume in 1 second (FEV), 62.8 vs. 57.7, p
Conclusions: S. aureus SAgs belonging to the EGC are highly prevalent in CF clinical isolates. The greater prevalence in these SAgs in CF airway specimens compared to skin isolates suggests that these toxins confer selective advantage in the CF airway.
Conclusions: The pattern of airway colonisation in the Indian setting is different from the Caucasian population, and P. aeruginosa and Burkholderia cepacia complex appear early. Colonisation with P. aeruginosa benefits from therapy. In case of infection, care must be taken while initiating empiric therapy. It should be based on local antibiograms to prevent the emergence of resistant microbes.
Publication date: Available online 11 November 2019Source: The Lancet Respiratory MedicineAuthor(s): Daniel J Wolter, Frankline M Onchiri, Julia Emerson, Mimi R Precit, Michael Lee, Sharon McNamara, Laura Nay, Marcella Blackledge, Ahmet Uluer, David M Orenstein, Michelle Mann, Wynton Hoover, Ronald L Gibson, Jane L Burns, Lucas R Hoffman, Daniel J Wolter, Frankline M Onchiri, Julia Emerson, Mimi R Precit, Michael LeeSummaryBackgroundStaphylococcus aureus is the bacterium cultured most often from respiratory secretions of people with cystic fibrosis. Both meticillin-susceptible S aureus and meticillin-resistant S aureus (MR...
ConclusionMRSA infection in our population with CF is common. Therefore, an eradication protocol should be instituted at an early stage to prevent chronic colonization. Children with persistent MRSA colonization have high morbidity and mortality rate.
We present a 23-year-old male with a history of cystic fibrosis (CF) with associated renal disease, bronchiectasis, pneumothorax, and distal intestinal obstruction syndrome admitted for CF exacerbation. Sputum culture was positive for methicillin resistant Staphylococcus aureus (MRSA). Chest imaging revealed extensive opacities in the left lung. His FEV1 during admission was 52% (baseline 70%). Allergy was consulted as inhaled vancomycin therapy was preferred, but the patient had previous vancomycin-induced reactions.
Conclusion and Relevance: Our study observed no difference in the effectiveness of vancomycin compared with linezolid in terms of change in lung function for APEs of CF. The rate of adverse drug events was low. In individuals with CF infected with MRSA who are experiencing an APE, either vancomycin or linezolid appear to be viable treatment options. PMID: 31658825 [PubMed - as supplied by publisher]
Background: In US cystic fibrosis (CF) patients, methicillin-resistant Staphylococcus aureus (MRSA) rates have tripled in the past 2 decades. Known clinical risk factors include exposure to a healthcare setting, Pseudomonas aeruginosa and CF-related diabetes. Area-level socio-environmental exposures have not been evaluated. We explored the association of area-level deprivation with MRSA prevalence in a pediatric CF Center in the Southeastern United States. Methods: Patients’ residential addresses were geocoded and linked to a composite Area Deprivation Index and Rural-Urban Commuting Area scores. The association...