title: Eradication of methicillin resistant Staphylococcus aureus detected for the first time in cystic fibrosis: A single center observational study.
abstract: To retrospectively identify CF patients with methicillin resistant Staphylococcus aureus (MRSA) and to assess the long-term success of an eradication scheme introduced in 2002 for all newly colonized patients.
  
  
  
  All microbiological results from all 505 CF patients followed between 2002 and 2012 were analyzed focusing on the detection of MRSA.
  
  
  
  Retrospective patient record analysis of MRSA positive CF patients regarding eradication and clinical outcome.
  
  
  
  We identified 57 patients with MRSA, mean age 15.3 years (range: 0.6-36.9, incidence 0.9%/year). Of these, nine patients were lost to follow-up; seven chronically colonized patients were excluded from the intervention. Eradication was suggested to all patients, 37/41 gave their consent to the following two-step approach: (i) dual iv antibiotic treatment over 3 weeks, accompanied by hygienic directives and topical therapy for 5 days followed by a 6-week period with dual oral antibiotic therapy and inhalation with vancomycin. (ii) Each new MRSA detection was treated with 6 weeks inhalation of vancomycin and topical therapy for 5 days. Long-term eradication was rated by the microbiological status in the third year after first detection. MRSA was eradicated in 31 of 37 patients (84%) whose clinical course was stable (mean FEV1 one year before MRSA 80.4%, 3 years after MRSA 81.0%).
  
  
  
  MRSA colonization mandates complex and expensive hygienic measures which are not well accepted by patients. Therefore, MRSA eradication is desirable. Intensive therapy regimens may be successful in patients with CF and might help to maintain a stable clinical course. Pediatr Pulmonol. 2016;51:1010-1019. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Children's University Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany. matthias.kappler@med.uni-muenchen.de.
authors.forename: Matthias
authors.initials: M
authors.lastname: Kappler
authors.affiliation: Children's University Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany.
authors.forename: Felicitas
authors.initials: F
authors.lastname: Nagel
authors.affiliation: Children's University Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany.
authors.forename: Maria
authors.initials: M
authors.lastname: Feilcke
authors.affiliation: Children's University Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany.
authors.forename: Carolin
authors.initials: C
authors.lastname: Kröner
authors.affiliation: Children's University Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany.
authors.forename: Ingo
authors.initials: I
authors.lastname: Pawlita
authors.affiliation: Department of Medicine of the Ludwig-Maximilians-University Munich, Munich, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Naehrig
authors.affiliation: Children's University Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Ripper
authors.affiliation: Children's University Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany.
authors.forename: Meike
authors.initials: M
authors.lastname: Hengst
authors.affiliation: Children's University Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: von Both
authors.affiliation: Children's University Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany.
authors.forename: Maria
authors.initials: M
authors.lastname: Forstner
authors.affiliation: Children's University Hospital of the University of Tübingen, Tübingen, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Hector
authors.affiliation: Children's University Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Griese
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000150:complications*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome; D014640:Vancomycin / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin
keywords: MRSA; eradication; methicillin resistant Staphylococcus aureus