Eradication of Methicillin-Resistant Staphylococcus aureus in Cystic Fibrosis

Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) in cystic fibrosis (CF) impairs lung function and contributes to the progression of the disease. Optimal eradication regimens for new-onset MRSA infections in people with CF (pwCF) remain undefined. Materials and Methods: This prospective, multicenter study evaluated a standardized, step-up MRSA eradication regimen in pwCF with new-onset MRSA infections between 2020 and 2022. Results: Ninety-one pwCF (52.7% male, median age: 9 years) were included. Our treatment regimen included oral rifampicin and co-trimoxazole or oral rifampicin and fusidic acid. Intravenous teicoplanin treatment was initiated in patients whose clinical condition was unstable. The eradication success rates after 1 year were 82.4%, 92.9%, and 55.6%, respectively. No significant changes in median FEV1% predicted or BMI z -scores were observed between MRSA-eradicated and non-eradicated groups at baseline or 12 months. Conclusion: A standardized step-up MRSA eradication protocol is effective for new-onset MRSA infections in pwCF. Randomized controlled trials are needed to confirm these findings.