Incidence and treatment of methicillin-resistant S. aureus infection in cystic fibrosis patients: a cohort study

Abstract

In Brazil the knowledge about methicillin-resistant Staphylococcus aureus infection in cystic fibrosis patients is scarce. This study aimed to determine the incidence of respiratory tract colonization and the identification rates after a standardized treatment. A retrospective cohort was performed highlighting the history of respiratory colonizations between January 2008 and June 2015. Patients under the age of 21 years with cystic fibrosis confirmed by sweat test or genetic study receiving care at the outpatient clinics of a Teaching Hospital were included. The treatment consisted of trimethoprim/sulfamethoxazole, rifampicin, nasal mupirocin and chlorhexidine 2%. The mean follow-up period was of 22.2 months and those with ≥3 negative cultures were considered free of methicillin-resistant Staphylococcus aureus. Forty-two patients were included. Methicillin-resistant Staphylococcus aureus was identified in six patients. Most patients had methicillin-sensitive S. aureus isolation prior to methicillin-resistant Staphylococcus aureus. Five children used the standardized treatment, none presented side effects. Only one child had a new isolation of methicillin-resistant Staphylococcus aureus during follow-up (after 20 months). The incidence of methicillin-resistant Staphylococcus aureus infection was high and occurred in young patients. The therapeutic regimen was effective, safe and being a good option to treat methicillin-resistant Staphylococcus aureus infection.

Upper Airway Findings and Markers of Lung Disease Progression in Patients with Cystic Fibrosis

“…However, larger samples might identify this germ and its relevance. 26 27 Considering the upper airway findings, we may suggest that patients with cystic fibrosis should be routinely evaluated by the ENT specialist, since the upper airway seems to contribute to the early identification of pathogens which are responsible for lower airway complications. In addition, the collection and culture of secretions of the nostril can contribute to identify some relevant infections of patients with CF, especially in cases of positive cultures for SA.…”

“…In addition, the collection and culture of secretions of the nostril can contribute to identify some relevant infections of patients with CF, especially in cases of positive cultures for SA. 26 …”

Desfechos clínicos associados à identificação de Staphylococcus aureus resistente à meticilina (MRSA) em secreção respiratória de lactentes e pré-escolares com fibrose cística

“…O Staphylococcus aureus é o primeiro e mais frequente patógeno isolado no trato respiratório de pessoas com FC, é uma bactéria coco gram positivo com metabolismo aeróbico que, em algumas situações pode atuar como anaeróbio (27,28). Como resposta adaptativa bacteriana, é capaz de produzir biofilme, característica significativa que protege o S.aureus contra defesas próprias do hospedeiro (27)(28)(29) .…”

“…A emergência de microrganismos multirresistentes na FC é, principalmente, resultado de múltiplos ciclos de antibióticos utilizados para tratamento de doenças do trato respiratório e devido às hospitalizações prolongadas (27).…”