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Treatment intensity and characteristics of MRSA infection in CF

Marianne S Muhlebach1, Meredith Miller, Lisa M LaVange

  • 1Department of Pediatrics, University of North Carolina, Chapel Hill, NC 27599-7217, USA.

Journal of Cystic Fibrosis : Official Journal of the European Cystic Fibrosis Society
|March 23, 2011
PubMed
Abstract

Insights

Methicillin-resistant Staphylococcus aureus (MRSA) strains impact clinical outcomes in cystic fibrosis (CF) patients. Different MRSA types influence antibiotic resistance and treatment intensity, though overall lung function and nutrition remain similar compared to MSSA.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Clinical Medicine

Background:

  • Increasing prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and the exchange between hospital-associated (SCCmec-II) and community (SCCmec-IV) strains.
  • The need to understand the impact of MRSA and its specific types on patient outcomes.

Purpose of the Study:

  • To assess the clinical outcomes, medication use, and antibiotic sensitivities associated with MRSA and different MRSA types in cystic fibrosis (CF) patients.
  • To compare these outcomes with methicillin-sensitive Staphylococcus aureus (MSSA) infected patients.

Main Methods:

  • MRSA isolates from CF patients were typed based on staphylococcal chromosomal cassette mec (SCCmec) and Panton-Valentine leukocidin (PVL) status.
  • Patient characteristics, lung function (FEV1), and nutritional status were compared between MRSA types and MSSA-infected controls matched for age, gender, and Pseudomonas aeruginosa infection.

Main Results:

  • PVL-negative SCCmec-II isolates were most common (72%). PVL-positive SCCmec-IV (USA300) strains were found in 17% of MRSA cases.
  • Patients with PVL-negative SCCmec-IV isolates exhibited the highest antibiotic resistance.
  • No significant differences in nutritional outcomes or FEV1 were observed between MRSA and MSSA patients, though MRSA patients received more intensive pulmonary maintenance therapy.

Conclusions:

  • Patients with chronic MRSA infections receive more intensive treatment compared to matched MSSA patients.
  • Clinical characteristics and treatment responses vary within MRSA-infected patients depending on the specific MRSA strain type.

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