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Mucoid Staphylococcus aureus: A Clinical Trial of Its Prevalence and Association with Lung Function in People with
Christine H Rumpf1, Timo Janssen1, Robert Jonathan Hait1
1Institute of Medical Microbiology.
Abstract:
Rationale: The mucoid phenotype of Staphylococcus aureus is caused by adaptation. Excessive biofilm formation associated with a protective effect for mucoid S. aureus was observed in isolates from respiratory samples of people with cystic fibrosis (pwCF). Objectives: There is little knowledge about the prevalence of mucoid S. aureus in pwCF and a potential association with CF lung disease. Methods: A prospective multicenter study was conducted (cross-sectional and longitudinal). Specimens and case report forms were sent to the central study laboratory for characterization of S. aureus and analysis of clinical parameters. Measurements and Main Results: In the cross-sectional study, in 41 (9.1%) of 451 S. aureus-positive pwCF from 13 CF centers, mucoid S. aureus was cultured. In the longitudinal study, the distribution of CFTR genotypes and the number of pwCF with highly effective modulator therapy and coinfection with Pseudomonas aeruginosa were equivalent in the mucoid group (35 pwCF) versus the control group (only nonmucoid S. aureus; 36 pwCF). Although lung function did not differ between groups as a whole, a subgroup analysis revealed significantly worse lung function for female pwCF with mucoid S. aureus as well as for pwCF if P. aeruginosa coinfection was excluded. Conclusions: In the era of highly effective modulator therapy, worse lung function was associated with female and P. aeruginosa-negative pwCF with mucoid S. aureus compared with pwCF with only nonmucoid S. aureus. Therefore, appropriate culture conditions should be established to detect mucoid S. aureus. Further investigations are needed to elucidate the relationship between mucoid S. aureus and CF lung disease. Clinical trial registered with www.clinicaltrials.gov (NCT04171583).
Insights
Mucoid Staphylococcus aureus, a biofilm-forming bacteria, is found in 9.1% of people with cystic fibrosis (pwCF). This phenotype is linked to worse lung function in female pwCF, especially without Pseudomonas aeruginosa co-infection.
Area of Science:
- Microbiology
- Pulmonology
- Genetics
Background:
- Mucoid Staphylococcus aureus exhibits excessive biofilm formation, potentially offering a protective advantage in cystic fibrosis (CF) lung infections.
- Prevalence and clinical impact of mucoid S. aureus in people with CF (pwCF) remain underexplored.
Purpose of the Study:
- To determine the prevalence of mucoid S. aureus in pwCF.
- To investigate the association between mucoid S. aureus and CF lung disease severity.
Main Methods:
- Prospective, multicenter study employing cross-sectional and longitudinal designs.
- Characterization of S. aureus isolates and analysis of clinical data from pwCF.
- Comparison of clinical parameters between mucoid S. aureus and non-mucoid S. aureus groups.
Main Results:
- Mucoid S. aureus was identified in 9.1% of S. aureus-positive pwCF across 13 centers.
- No overall difference in lung function between mucoid and non-mucoid groups.
- Subgroup analysis revealed significantly worse lung function in female pwCF with mucoid S. aureus and in pwCF without Pseudomonas aeruginosa co-infection.
Conclusions:
- Mucoid S. aureus is associated with poorer lung function in specific subgroups of pwCF, particularly females and those without P. aeruginosa.
- Optimized culture methods are crucial for detecting mucoid S. aureus.
- Further research is required to fully understand the S. aureus-mucoid phenotype's role in CF lung disease progression.
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