Antimicrobial Treatment of Staphylococcus aureus in Patients With Cystic Fibrosis

Esposito, Susanna; Pennoni, Guido; Mencarini,; Palladino, Nicola; L, Peccini; Principi, Nicola

doi:10.3389/fphar.2019.00849

Cited by 33 publications

(27 citation statements)

References 93 publications

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“…Antibiotic failure and recurrent infections in CF patients are of critical concern. CF patients with chronic S. aureus respiratory infections can have frequent respiratory exacerbations that require antibiotic treatments, and it is common for these patients to simultaneously receive multiple antibiotics to treat co-infecting bacteria, including MSSA, MRSA, and P. aeruginosa 43 . MER is frequently used to treat P. aeruginosa infections [44][45][46] , and the cephalosporin CPT is increasingly being used against MRSA infections [47][48][49][50] .…”

Section: Discussionmentioning

confidence: 99%

Carbapenems drive the collateral resistance to ceftaroline in cystic fibrosis patients with MRSA

et al. 2020

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Chronic airways infection with methicillin-resistant Staphylococcus aureus (MRSA) is associated with worse respiratory disease cystic fibrosis (CF) patients. Ceftaroline is a cephalosporin that inhibits the penicillin-binding protein (PBP2a) uniquely produced by MRSA. We analyzed 335 S. aureus isolates from CF sputum samples collected at three US centers between 2015–2018. Molecular relationships demonstrated that high-level resistance of preceding isolates to carbapenems were associated with subsequent isolation of ceftaroline resistant CF MRSA. In vitro evolution experiments showed that pre-exposure of CF MRSA to meropenem with further selection with ceftaroline implied mutations in mecA and additional mutations in pbp1 and pbp2, targets of carbapenems; no effects were achieved by other β-lactams. An in vivo pneumonia mouse model showed the potential therapeutic efficacy of ceftaroline/meropenem combination against ceftaroline-resistant CF MRSA infections. Thus, the present findings highlight risk factors and potential therapeutic strategies offering an opportunity to both prevent and address antibiotic resistance in this patient population.

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Section: Discussionmentioning

confidence: 99%

Carbapenems drive the collateral resistance to ceftaroline in cystic fibrosis patients with MRSA

et al. 2020

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“…Bacterial infections are extremely common and cause lung deterioration and remodeling quite similar to those associated with ABPA [5]. Moreover, co-infections are frequent in CF patients and specific signs as well as symptoms are not pathognomonic of a definitive etiology [13,14]. On the other hand, M. pneumoniae is not frequently associated with pulmonary exacerbation in patients with CF [2] and recent studies have shown that it presents with clinical, laboratory and radiographic findings similar to those due to typical bacterial infections [15,16].…”

Section: Discussionmentioning

confidence: 99%

A Peculiar Case of Pneumonia due to Mycoplasma pneumoniae in a Child with Cystic Fibrosis and Sensibilization to Aspergillus fumigatus

Pennoni

Mencarini³

et al. 2019

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Aspergillus fumigatus plays a major role in pulmonary exacerbations in patients with cystic fibrosis. The most common A. fumigatus diseases are those based on immune-mediated response to A. fumigatus antigens; including allergic bronchopulmonary aspergillosis (ABPA). In this condition; the presence of A. fumigatus in the lower respiratory tract triggers an IgE-mediated hypersensitivity response that causes airway inflammation; bronchospasms; and bronchiectasis. This case report describes a ten-year-old male patient suffering from cystic fibrosis (CF) in whom the diagnosis of ABPA occurred in association with pneumonia due to Mycoplasma pneumoniae more than two weeks after hospitalization. This case is a good example of how difficult the identification of ABPA in CF patients can be and highlights that ABPA can occur in association with co-infections due to other pathogens. In order to avoid the risk of a late ABPA diagnosis, it is imperative that the diagnostic criteria guidelines are reviewed and standardized. Author Contributions: L.P. and S.P. co-wrote the first draft of the manuscript; V.M. and N.P. (Nicola Palladino) were in charge of patient's management; M.S. performed the literature review; N.P. (Nicola Principi) gave a substantial scientific contribution; G.P. supervised patient's management; S.E. supervised the project and made substantial scientific contributions. All authors have read and agreed to the published version of the manuscript. Funding: This research received no external funding. Conflicts of Interest:The authors declare no conflict of interest.

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“…Along with inhaled antibiotic strategies for eradicating P. aeruginosa in CF patients, novel therapeutic protocols have been proposed for the eradication of MRSA or emerging Bcc pathogens. Numerous protocols for the early eradication of MRSA have been reported to prevent the negative clinical implications of MRSA colonization [ 80 ]. A recent systemic review published by Lo et al examined two trials with MRSA-infected patients; in both, the active treatment was oral trimethoprim and sulfamethoxazole associated with rifampicin, while the control arm was observational only [ 81 ].…”

Section: Antibiotic Strategies For Eradicating P Aerugimentioning

confidence: 99%

Cystic Fibrosis: Recent Insights into Inhaled Antibiotic Treatment and Future Perspectives

et al. 2021

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Although new inhaled antibiotics have profoundly improved respiratory diseases in cystic fibrosis (CF) patients, lung infections are still the leading cause of death. Inhaled antibiotics, i.e., colistin, tobramycin, aztreonam lysine and levofloxacin, are used as maintenance treatment for CF patients after the development of chronic Pseudomonas aeruginosa (P. aeruginosa) infection. Their use offers advantages over systemic therapy since a relatively high concentration of the drug is delivered directly to the lung, thus, enhancing the pharmacokinetic/pharmacodynamic parameters and decreasing toxicity. Notably, alternating treatment with inhaled antibiotics represents an important strategy for improving patient outcomes. The prevalence of CF patients receiving continuous inhaled antibiotic regimens with different combinations of the anti-P. aeruginosa antibiotic class has been increasing over time. Moreover, these antimicrobial agents are also used for preventing acute pulmonary exacerbations in CF. In this review, the efficacy and safety of the currently available inhaled antibiotics for lung infection treatment in CF patients are discussed, with a particular focus on strategies for eradicating P. aeruginosa and other pathogens. Moreover, the effects of long-term inhaled antibiotic therapy for chronic P. aeruginosa infection and for the prevention of pulmonary exacerbations is reviewed. Finally, how the mucus environment and microbial community richness can influence the efficacy of aerosolized antimicrobial agents is discussed.

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Antimicrobial Treatment of Staphylococcus aureus in Patients With Cystic Fibrosis

Cited by 33 publications

References 93 publications

Carbapenems drive the collateral resistance to ceftaroline in cystic fibrosis patients with MRSA

Carbapenems drive the collateral resistance to ceftaroline in cystic fibrosis patients with MRSA

A Peculiar Case of Pneumonia due to Mycoplasma pneumoniae in a Child with Cystic Fibrosis and Sensibilization to Aspergillus fumigatus

Cystic Fibrosis: Recent Insights into Inhaled Antibiotic Treatment and Future Perspectives

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