title: MRSA eradication of newly acquired lower respiratory tract infection in cystic fibrosis.
abstract: UK cystic fibrosis (CF) guidelines recommend eradication of methicillin-resistantStaphylococcus aureus(MRSA) when cultured from respiratory samples. As there is no clear consensus as to which eradication regimen is most effective, we determined the efficacy of eradication regimens used in our CF centre and long-term clinical outcome. All new MRSA positive sputum cultures (n=37) that occurred between 2000 and 2014 were reviewed. Eradication regimen characteristics and clinical, microbiological and long-term outcome data were collected. Rifampicin plus fusidic acid was the most frequently used regimen (24 (65%) out of 37 patients), with an overall success rate of 79% (19 out of 24 patients). Eradication failure was more likely in patients with an additional MRSA-positive peripheral screening swab (p=0.03) and was associated with worse survival (p=0.04). Our results demonstrate the feasibility and clinical benefits of MRSA eradication. As peripheral colonisation was associated with lower eradication success, strategies combining systemic and topical treatments should be considered to optimise outcomes in CF patients.
authors.affiliation: Cystic Fibrosis & Airways Microbiology Research Group, Queen's University Belfast, Belfast, UK; Centre for Infection and Immunity, Queen's University Belfast, Belfast, UK.
authors.forename: Emilie
authors.initials: E
authors.lastname: Vallières
authors.affiliation: Cystic Fibrosis & Airways Microbiology Research Group, Queen's University Belfast, Belfast, UK; Northern Ireland Regional Adult CF Centre, Belfast, UK.
authors.forename: Jacqueline C
authors.initials: JC
authors.lastname: Rendall
authors.affiliation: Centre for Infection and Immunity, Queen's University Belfast, Belfast, UK; Dept of Bacteriology, Belfast Health and Social Care Trust, Belfast, UK; School of Biomedical Sciences, Ulster University, Coleraine, UK.
authors.forename: John E
authors.initials: JE
authors.lastname: Moore
authors.affiliation: Northern Ireland Regional Adult CF Centre, Belfast, UK; Dept of Bacteriology, Belfast Health and Social Care Trust, Belfast, UK.
authors.forename: John
authors.initials: J
authors.lastname: McCaughan
authors.affiliation: Dept of Neurosciences, University of Edinburgh, Western General Hospital, Edinburgh, UK.
authors.forename: Anne I
authors.initials: AI
authors.lastname: Hoeritzauer
authors.affiliation: Cystic Fibrosis & Airways Microbiology Research Group, Queen's University Belfast, Belfast, UK; School of Pharmacy, Queen's University Belfast, Belfast, UK.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Tunney
authors.affiliation: Cystic Fibrosis & Airways Microbiology Research Group, Queen's University Belfast, Belfast, UK; Centre for Infection and Immunity, Queen's University Belfast, Belfast, UK; Northern Ireland Regional Adult CF Centre, Belfast, UK.
authors.forename: Joseph Stuart
authors.initials: JS
authors.lastname: Elborn
authors.affiliation: Cystic Fibrosis & Airways Microbiology Research Group, Queen's University Belfast, Belfast, UK; Northern Ireland Regional Adult CF Centre, Belfast, UK.
authors.forename: Damian G
authors.initials: DG
authors.lastname: Downey