Patient segregation and aggressive antibiotic eradication therapy can control methicillin-resistant Staphylococcus aureus at large cystic fibrosis centres.
BACKGROUND
The prevalence of MRSA in patients with CF has risen in recent years. We adhere to a policy of segregation and barrier nursing to manage patients with MRSA, and we actively pursue eradication of MRSA. We have evaluated our experiences of MRSA infection in our large adult CF centre.


METHODS
A retrospective review of all MRSA-positive patients from 1998 to 2008 was undertaken. Isolates were subjected to molecular identification to elucidate possible patient-to-patient transmission events. Eradication attempts were scrutinised.


RESULTS
We have maintained a low incidence and prevalence (below 3%) of MRSA within this large cohort. A total of 15 pulsotypes of MRSA were identified among the 24 isolates examined, epidemiological data suggested no patient-patient transmission. Based on 6 month follow-up data, successful eradication was achieved in 81% patients. This includes those who had harboured infection for some time. Twenty-one (80.8%) required only one course of treatment, 3 (11.6%) patients required two different regimes and 2 (7.5%) required three courses to fully eradicate the organism.


CONCLUSIONS
Strict infection control procedures can control MRSA infection and keep the prevalence low in CF clinics. Eradication is achievable in the majority of patients even when significant time has lapsed from initial isolation. In some instances, up to 3 courses of antibiotics were required to achieve eradication.
Doe
S J
SJ
Manchester Adult CF Centre, University Hospitals of South Manchester NHS Foundation Trust, Manchester M23 9LT, UK. simondoe@doctors.org.uk
McSorley
A
A
Isalska
B
B
Kearns
A M
AM
Bright-Thomas
R
R
Brennan
A L
AL
Webb
A K
AK
Jones
A M
AM
D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015373:Bacterial Typing Techniques; D015331:Cohort Studies; D003550:Cystic Fibrosis / Q000382:microbiology*; D004359:Drug Therapy, Combination; D016521:Electrophoresis, Gel, Pulsed-Field; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000379:methods; D007297:Inpatients; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification / Q000187:drug effects / Q000235:genetics; D010356:Patient Isolation; D015995:Prevalence; D019233:Retreatment; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000150:complications* / Q000188:drug therapy* / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult
D000900:Anti-Bacterial Agents