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

McSorley, Aileen; Isalska, B.; Kearns, Angela; Bright-Thomas, R.J.; Brennan, A.; Webb, A K; Jones, Andrew M.

doi:10.1016/j.jcf.2009.11.009

Cited by 37 publications

(39 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In 2008 the Cystic Fibrosis Trust published a comprehensive report with specific recommendations for the management of MRSA in CF centers including addressing segregation, hygiene and surveillance [7]. Segregation and eradication have been shown to be successful in keeping the prevalence of MRSA infection low [21], and minimize the likelihood of cross-infection. None of the MRSA positive patients under study received eradication treatment, but they did receive standard anti-MRSA treatment (vancomycin intravenously or linezolid orally) when they were hospitalized for any infectious exacerbation.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and impact on FEV1 decline of chronic methicillin-resistant Staphylococcus aureus (MRSA) colonization in patients with Cystic Fibrosis

Vanderhelst

Meırleır

Verbanck

et al. 2012

Journal of Cystic Fibrosis

View full text Add to dashboard Cite

In our center the prevalence of MRSA in CF patients, chronically colonized with S. aureus and over the age of 4 years, was 15.2% (12.6% chronic infection). MRSA colonization was shown to be associated with a genotype F508del, presence of bronchiectasis and hospitalization. Our spirometric data also show that a MRSA episode entails an FEV(1) decline that is almost double that predicted for CF patients who can remain unaffected by MRSA.

show abstract

Section: Discussionmentioning

confidence: 99%

Prevalence and impact on FEV1 decline of chronic methicillin-resistant Staphylococcus aureus (MRSA) colonization in patients with Cystic Fibrosis

Vanderhelst

Meırleır

Verbanck

et al. 2012

Journal of Cystic Fibrosis

View full text Add to dashboard Cite

show abstract

“…Doe and colleagues (41) reported that patient segregation and aggressive antibiotic eradication therapy can achieve eradication in the majority of patients with CF. Numerous antibiotic regimens were used; however, the most successful were those regimens that included two oral antibiotics (one of which was rifampin) and nebulized vancomycin.…”

Section: Methicillin-resistant Staphylococcus Aureusmentioning

confidence: 99%

“…Because MRSA is often found outside of the respiratory tract, an eradication attempt may also include treatment with nasal mupirocin and chlorhexidine or bleach baths. Interestingly, in contrast to P. aeruginosa, there is some evidence that chronic MRSA may be eradicated from the respiratory tract (41). Given that oral antibiotics alone may not be enough to eradicate chronic MRSA, the addition of inhaled antibiotics targeting MRSA also may be considered.…”

Section: Methicillin-resistant Staphylococcus Aureusmentioning

confidence: 99%

Antibiotic Management of Lung Infections in Cystic Fibrosis. I. The Microbiome, Methicillin-Resistant Staphylococcus aureus, Gram-Negative Bacteria, and Multiple Infections

et al. 2014

View full text Add to dashboard Cite

Despite significant advances in treatment strategies targeting the underlying defect in cystic fibrosis (CF), airway infection remains an important cause of lung disease. In this two-part series, we review recent evidence related to the complexity of CF airway infection, explore data suggesting the relevance of individual microbial species, and discuss current and future treatment options. In Part I, the evidence with respect to the spectrum of bacteria present in the CF airway, known as the lung microbiome is discussed. Subsequently, the current approach to treat methicillin-resistant Staphylococcus aureus, gram-negative bacteria, as well as multiple coinfections is reviewed. Newer molecular techniques have demonstrated that the airway microbiome consists of a large number of microbes, and the balance between microbes, rather than the mere presence of a single species, may be relevant for disease pathophysiology. A better understanding of this complex environment could help define optimal treatment regimens that target pathogens without affecting others. Although relevance of these organisms is unclear, the pathologic consequences of methicillin-resistant S. aureus infection in patients with CF have been recently determined. New strategies for eradication and treatment of both acute and chronic infections are discussed. Pseudomonas aeruginosa plays a prominent role in CF lung disease, but many other nonfermenting gram-negative bacteria are also found in the CF airway. Many new inhaled antibiotics specifically targeting P. aeruginosa have become available with the hope that they will improve the quality of life for patients. Part I concludes with a discussion of how best to treat patients with multiple coinfections.

show abstract

“…Initial improvements in care included the introduction of pancreatic enzyme replacement therapy (PERT) in the 1960s and enteric coated enzymes in the early 1980s to treat pancreatic insufficiency in combination with a high calorie, high fat diet. Systemic antibiotic therapy for lung infection, initially for Staphylococcus aureus and subsequently against Gram-negative organisms such as Pseudomonas aeruginosa and the development and use of inhaled antibiotic therapies over successive decades have been important therapeutic developments [4][5][6]. Advances in antibiotic therapy, the introduction of mucolytics including dornase alpha (Pulmozyme), hypertonic saline and more effective methods of airway clearance have contributed to the major therapeutic advances from the 1970s to the current era [7].…”

Section: Introductionmentioning

confidence: 99%

Report of the European Respiratory Society/European Cystic Fibrosis Society task force on the care of adults with cystic fibrosis

et al. 2015

View full text Add to dashboard Cite

The improved survival in people with cystic fibrosis has led to an increasing number of patients reaching adulthood. This trend is likely to be maintained over the next decades, suggesting a need to increase the number of centres with expertise in the management of adult patients with cystic fibrosis. These centres should be capable of delivering multidisciplinary care addressing the complexity of the disease, in addition to addressing the psychological burden on patients and their families. Further issues that require attention are organ transplantation and end of life management.Lung disease in adults with cystic fibrosis drives most of the clinical care requirements, and major lifethreatening complications, such as respiratory infection, respiratory failure, pneumothorax and haemoptysis, and the management of lung transplantation require expertise from trained respiratory physicians. The taskforce therefore strongly reccommends that medical leadership in multidisciplinary adult teams should be attributed to a respiratory physician adequately trained in cystic fibrosis management.The task force suggests the implementation of a core curriculum for trainees in adult respiratory medicine and the selection and accreditation of training centres that deliver postgraduate training to the standards of the HERMES programme. @ERSpublications Respiratory physicians, trained in adult CF management, should lead multidisciplinary teams taking care of patients http://ow.ly/SgRgj

show abstract

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

Cited by 37 publications

References 29 publications

Prevalence and impact on FEV1 decline of chronic methicillin-resistant Staphylococcus aureus (MRSA) colonization in patients with Cystic Fibrosis

Prevalence and impact on FEV1 decline of chronic methicillin-resistant Staphylococcus aureus (MRSA) colonization in patients with Cystic Fibrosis

Antibiotic Management of Lung Infections in Cystic Fibrosis. I. The Microbiome, Methicillin-Resistant Staphylococcus aureus, Gram-Negative Bacteria, and Multiple Infections

Report of the European Respiratory Society/European Cystic Fibrosis Society task force on the care of adults with cystic fibrosis

Contact Info

Product

Resources

About