Epidemiological Analysis of Methicillin-ResistantStaphylococcus aureusIsolates From Adult Patients With Cystic Fibrosis

Abstract

Using pulsed-field gel electrophoresis, we genotyped 21 methicillin-resistantStaphylococcus aureusisolates from patients attending an adult cystic fibrosis unit. Eleven patients exhibited pulsotypes related to 2 locally endemic strains. Eleven chronically colonized patients were assessed over a period of up to 2 years, and all demonstrated a retention of strain type.

Patient segregation and aggressive antibiotic eradication therapy can control methicillin-resistant Staphylococcus aureus at large cystic fibrosis centres

“…Molecular analysis has been demonstrated to suggest cross-infection of MRSA as identical clones have been isolated from different patients [25]. Another study confirms our findings as 6 different pulsotypes of MRSA were identified from 7 patients suggesting a low level of transmission between patients [26].…”

MRSA eradication in a health care worker with cystic fibrosis; re-emergence or re-infection?

“…Our patient did not have an admission to the CF unit and was seen separately from other CF patients as an outpatient. Previous work at our hospital in adults with CF with MRSA demonstrated that 47% of MRSA isolates were genetically distinct from local endemic strains [14]. As she worked as a HCW and close contact is required for MRSA acquisition [15], it is possible that she reacquired MRSA from patient contact at work.…”

Treatment decisions for MRSA in patients with cystic fibrosis (CF): when is enough, enough?

“…While not well defined in the literature transient infection with MRSA is well known and could be as high as 50% in some studies19 20 and the authors state 30% of patients with a positive culture reported in the US Cystic Fibrosis Foundation (CFF) Patient Registry do not have chronic infection. Several other studies suggest chronic infection is not universal but is difficult to estimate due to early treatment 10 14 15.…”

“…Rates of long-term eradication from sputum appear not to exceed 50% and could be much lower 9 10. MRSA susceptibility varies globally19 20 30 and may include S. aureus which is multiresistant and where sodium fuscidate (not licenced in the USA) and rifampicin are prescribed 9 10 14 15…”