Infection Control Recommendations for Patients With Cystic Fibrosis: Microbiology, Important Pathogens, and Infection Control Practices to Prevent Patient-to-Patient Transmission

Abstract

Infection Control Recommendations for Patients With Cystic Fibrosis: Microbiology, Important Pathogens, and Infection Control Practices to Prevent Patient-to-Patient Transmissionupdates, expands, and replaces the consensus statement,Microbiology and Infectious Disease in Cystic Fibrosispublished in 1994. This consensus document presents background data and evidence-based recommendations for practices that are intended to decrease the risk of transmission of respiratory pathogens among CF patients from contaminated respiratory therapy equipment or the contaminated environment and thereby reduce the burden of respiratory illness. Included are recommendations applicable in the acute care hospital, ambulatory, home care, and selected non-healthcare settings. The target audience includes all healthcare workers who provide care to CF patients. Antimicrobial management is beyond the scope of this document.

Changing Epidemiology of the Respiratory Bacteriology of Patients With Cystic Fibrosis

“…For over a decade, CF centers have been progressively implementing more rigorous infection prevention and control strategies to reduce the risk for patient-to-patient transmission of CF pathogens and acquisition from the natural and/or health-care environment. 22,23 Furthermore, the prevalence of B cepacia complex, H influenzae, and P aeruginosa also decreased. While successful early eradication strategies for P aeruginosa have been well studied, 24,25 eradication studies have not been performed for B cepacia complex and H influenzae.…”

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

“…However, more than 47% of isolates were genetically distinct from either of these endemic strains. In line with infection control guidelines for patients with CF, 7 patients CF and MRSA colonization or infection are routinely admitted to a separate ward (the infectious diseases ward) and attend separate outpatient clinics.…”

Is there value in susceptibility testing ofPseudomonas aeruginosacausing chronic infection in patients with cystic fibrosis?

“…When the agar-based methods, disk diffusion and E-tests, were compared with reference methods, they showed excellent concordance [14]. As a result, the US Cystic Fibrosis Foundation recommended that disk diffusion or E-test be the method of choice for susceptibility testing of this organism [15]. However, in a recent survey of microbiology laboratories servicing US CF centers, only a little over half (52%) were following this recommendation [16].…”