Phenotypic characteristics of incident and chronic MRSA isolates in cystic fibrosis

Gilpin, D.F.; Hoffman, Lucas R.; Ceppe, Agathe; Muhlebach, Marianne S.

doi:10.1016/j.jcf.2021.05.015

Cited by 12 publications

(15 citation statements)

References 37 publications

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“…identical to our study [35,36]. Several reports have suggested that chronic MRSA infection is associated with a high decline rate of lung function, failure to recover lung function after a pulmonary exacerbation and decreased survival [37,38]. Te prevalence of MRSA in our study was 20% which is similar to Chmiel et al who reported the prevalence of MRSA infection at 25% in the USA, as compared to 11% in Canada and Europe [39].…”

Section: Discussionsupporting

confidence: 90%

Distribution and Characteristics of Bacteria Isolated from Cystic Fibrosis Patients with Pulmonary Exacerbation

Erfanimanesh

Emaneini

Modaresi

et al. 2022

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Background. Cystic fibrosis (CF) is an inherited recessive disorder characterized by recurrent and persistent pulmonary infections, resulting in lung function deterioration and early mortality. Methods. A cross-sectional study was conducted on the bacterial profile and antibiotic resistance pattern of 103 respiratory specimens from CF patients with signs of pulmonary exacerbation. Antibiotic susceptibility testing and biofilm formation of Staphylococcus aureus and Pseudomonas aeruginosa isolates were performed by the Kirby–Bauer disc diffusion method and microtiter plate assay, respectively. Molecular typing of S. aureus and P. aeruginosa isolates was carried out by spa typing and repetitive extragenic palindromic element PCR. Results. In a total of 129 isolates, the most prevalent organisms were S. aureus (55.3%) and P. aeruginosa (41.7%). Other less prevalent bacterial isolates include coagulase-negative staphylococci, Escherichia coli, klebsiella spp., Enterobacter spp., and Achromobacter xylosoxidans. The highest rate of resistance for S. aureus was observed to azithromycin and erythromycin (80%), ciprofloxacin (52.3%), clindamycin (44.6%) and tetracycline (43%). Twenty percent of S. aureus isolates were methicillin-resistant S. aureus (MRSA) and 47.6% were MDR S. aureus. For P. aeruginosa isolates the highest resistance was to cefepime (38.3%) and levofloxacin (33.3%) and 20% showed MDR phenotype. Conclusion. Our study demonstrated a significant decline in the prevalence of P. aeruginosa infections in comparison to previous studies. We found S. aureus to be more prevalent in younger patients, whereas mucoid P. aeruginosa showed a shift in prevalence toward older ages. Molecular typing methods showed great diversity between isolates.

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Section: Discussionsupporting

confidence: 90%

Distribution and Characteristics of Bacteria Isolated from Cystic Fibrosis Patients with Pulmonary Exacerbation

Erfanimanesh

Emaneini

Modaresi

et al. 2022

Canadian Journal of Infectious Diseases and Medical Microbiolog

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“…The antibiofilm activity of antibiotics on S. aureus isolated from CF patients has been scarcely investigated. Considering the 5 antibiotics included in this work, a PubMed search conducted on July 19, 2021, with « ceftaroline » or « ceftobiprole » or « linezolid » or « rifampicin » or « trimethoprim » and « Staphylococcus aureus » and « cystic fibrosis » and « biofilm » found five non-redundant publications supporting the need for data acquisition on the subject of antibiotics' antibiofilm activity against CF S. aureus isolates (Molina et al, 2008;Aktas et al, 2013;Iglesias et al, 2019;Gilpin et al, 2021;Harrington et al, 2021). This is reinforced by the observations that most of these antimicrobial agents have been found to display an antibiofilm activity on S. aureus isolated in other settings.…”

Section: Discussionmentioning

confidence: 93%

Biofilm Formation in Methicillin-Resistant Staphylococcus aureus Isolated in Cystic Fibrosis Patients Is Strain-Dependent and Differentially Influenced by Antibiotics

et al. 2021

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Cystic fibrosis (CF) is a genetic disease with lung abnormalities making patients particularly predisposed to pulmonary infections. Staphylococcus aureus is the most frequently identified pathogen, and multidrug-resistant strains (MRSA, methicillin-resistant S. aureus) have been associated with more severe lung dysfunction leading to eradication recommendations. Diverse bacterial traits and adaptive skills, including biofilm formation, may, however, make antimicrobial therapy challenging. In this context, we compared the ability of a collection of genotyped MRSA isolates from CF patients to form biofilm with and without antibiotics (ceftaroline, ceftobiprole, linezolid, trimethoprim, and rifampicin). Our study used standardized approaches not previously applied to CF MRSA, the BioFilm Ring test® (BRT®), the Antibiofilmogram®, and the BioFlux™ 200 system which were adapted for use with the artificial sputum medium (ASM) mimicking conditions more relevant to the CF lung. We included 63 strains of 10 multilocus sequence types (STs) isolated from 35 CF patients, 16 of whom had chronic colonization. The BRT® showed that 27% of the strains isolated in 37% of the patients were strong biofilm producers. The Antibiofilmogram® performed on these strains showed that broad-spectrum cephalosporins had the lowest minimum biofilm inhibitory concentrations (bMIC) on a majority of strains. A focus on four chronically colonized patients with inclusion of successively isolated strains showed that ceftaroline, ceftobiprole, and/or linezolid bMICs may remain below the resistance thresholds over time. Studying the dynamics of biofilm formation by strains isolated 3years apart in one of these patients using BioFlux™ 200 showed that inhibition of biofilm formation was observed for up to 36h of exposure to bMIC and ceftaroline and ceftobiprole had a significantly greater effect than linezolid. This study has brought new insights into the behavior of CF MRSA which has been little studied for its ability to form biofilm. Biofilm formation is a common characteristic of prevalent MRSA clones in CF. Early biofilm formation was strain-dependent, even within a sample, and not only observed during chronic colonization. Ceftaroline and ceftobiprole showed a remarkable activity with a long-lasting inhibitory effect on biofilm formation and a conserved activity on certain strains adapted to the CF lung environment after years of colonization.

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“…The significance of oropharyngeal swabs was equivalent to sputum and BALF; however, they were compromised by oral flora. Literature data supports that swabs from the posterior pharyngeal wall poorly reflect the microbial composition of the lungs [2,19,20]. BALF is the deepest and the most accurate sample but is invasive and requires general anaesthesia, especially in children.…”

Section: Discussionmentioning

confidence: 99%

“…Staphylococcus aureus and Pseudomonas aeruginosa are multifaced microorganisms exhibiting various adaptive mechanisms and phenotypes, including changes in metabolism, resistance to antimicrobial drugs, and enhanced capacity for biofilm formation and anaerobic growth. Another adaptation lies in slight colony variants (SCV), which have been shown to typically occur during chronic infection and with extensive use of trimethoprim-sulfamethoxazole [2,3]. Simultaneously, the dysfunction of the cystic fibrosis conductance regulator (CFTR) also causes a progressive reduction of the commensal diversity in the respiratory tract [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

“…Molecular laboratory methods have opened new data about the microbial composition of airways in people with CF; however, the culture-based technique remains the method of choice under advanced and resource-limited conditions [1,2]. These are reasonable if they aim to find obligate pathobionts associated with CF and assess their susceptibility to antimicrobials [1,2,6]. However, the lung microbiome is an attractive target for diagnostic tools, helping monitor the disease stage and being used to predict exacerbations [5].…”

Section: Introductionmentioning

confidence: 99%

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Culture-dependent evaluation of the respiratory microbiome in children with cystic fibrosis

et al. 2022

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The study aimed to assess the regional peculiarities of the respiratory profile of children with cystic fibrosis (CF) in the Dnipro region (Ukraine). Methods. Children living in the Dnipro region and aged younger than 18 years old with molecular-genetic confirmation of CF were enrolled in the study. Lung colonization was evaluated using a culture-dependent method. Sputum, mucus from the posterior pharyngeal wall and bronchoalveolar lavage fluid (BALF) were utilized. Results. The Firmicutes phylum was the most common and occupied 54.00 % of the general proportion. On the other hand, the Proteobacteria phylum demonstrated overexpression in CF airways and kept the second rank with 28.87 %. Sorensen's species similarity coefficient showed an allied affinity between the microbial burden of oropharyngeal samples with nasopharyngeal and sputum, QS = 0.61 and 0.91, respectively. However, the species composition within the nasal cavity was distinct from sputum and BALF (QS=0.47). The primary pathogens in childhood were S. aureus, H. influenza, P. aeruginosa and A. fumigatus. In contrast to gram-negative non-fermenters (GNNF), the prevalence of S. aureus isolates by age had a non-linear character. The commensal microbiota changed negatively with age. Among children under 12 years, the Streptococcus genus was identified in 23.08 % of the samples, but among the age category older than 15 – only in 9.22 %. 11.06 % of S. aureus had small colony variants (SCVs) morphotypes. Isolates of P. aeruginosa with the properties of SCVs were also found in children who underwent prolonged antimicrobial treatment. However, the most prominent was the mucoid phenotype – 34.31 % of isolates. Conclusions. Along with conventional microbiological properties, obligate pathobionts in children with CF exhibited changes, resulting in difficulties in identification. These included auxotrophic modification into SCVs and mucoid transformation. The culture-dependent technique gives crucial data about the profile of pathogens usually associated with CF, although it is sufficiently limited

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Phenotypic characteristics of incident and chronic MRSA isolates in cystic fibrosis

Cited by 12 publications

References 37 publications

Distribution and Characteristics of Bacteria Isolated from Cystic Fibrosis Patients with Pulmonary Exacerbation

Distribution and Characteristics of Bacteria Isolated from Cystic Fibrosis Patients with Pulmonary Exacerbation

Biofilm Formation in Methicillin-Resistant Staphylococcus aureus Isolated in Cystic Fibrosis Patients Is Strain-Dependent and Differentially Influenced by Antibiotics

Culture-dependent evaluation of the respiratory microbiome in children with cystic fibrosis

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