title: Successful decolonization of methicillin-resistant Staphylococcus aureus in paediatric patients with cystic fibrosis (CF) using a three-step protocol.
abstract: Methicillin-resistant Staphylococcus aureus (MRSA) is recognized as a bacterial pathogen in patients with cystic fibrosis (CF) although its clinical effects can be variable. The aim of this study was to evaluate the efficacy of a three-step decolonization protocol for MRSA (Belfast CF MRSA decolonization protocol). Of the 17 paediatric patients treated during the five years of the study, eight (47%) were successfully decolonized following one five-day course of oral rifampicin and fusidic acid. The success rate increased to 12 (71%) patients after a second five-day oral treatment course in the 11 patients who remained culture positive at the end of the first treatment cycle. In a further four patients, clearance was achieved with a course of intravenous teicoplanin, increasing the decolonization rate to 16 of 17 patients (94%). These results compare favourably with other published studies and show that MRSA decolonization can be successful in a high proportion of paediatric CF patients.
authors.affiliation: Northern Ireland Paediatric CF Centre, Royal Belfast Hospital for Sick Children, Royal Group of Hospitals, Belfast, Northern Ireland, UK.
authors.forename: M
authors.initials: M
authors.lastname: Macfarlane
authors.forename: A
authors.initials: A
authors.lastname: Leavy
authors.forename: J
authors.initials: J
authors.lastname: McCaughan
authors.forename: R
authors.initials: R
authors.lastname: Fair
authors.forename: A J M
authors.initials: AJ
authors.lastname: Reid
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000150:complications / Q000382:microbiology*; D004359:Drug Therapy, Combination; D005260:Female; D005672:Fusidic Acid / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D008297:Male; D016106:Methicillin Resistance / Q000187:drug effects*; D011014:Pneumonia / Q000188:drug therapy*; D012293:Rifampin / Q000627:therapeutic use; D012720:Severity of Illness Index; D013183:Sputum / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000517:prevention & control; D013211:Staphylococcus aureus / Q000187:drug effects*; D017334:Teicoplanin / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D005672:Fusidic Acid; D017334:Teicoplanin; D012293:Rifampin