Successful eradication of methicillin-resistant staphylococcus aureus in chronically colonized cystic fibrosis patients

Background: Chronic colonization of methicillin-resistant Staphylococcus aureus (MRSA) in patients with Cystic Fibrosis is an increasing clinical problem, and therapeutic options are limited. Chronic colonization with MRSA can be associated with accelerated decline in lung function; therefore eradication of MRSA is attempted in most CF centres today. The aim of this study was to determine whether it is possible to eradicate MRSA from airways of Cystic Fibrosis patients with prolonged combination of oral antibiotics. Results: Eleven Cystic Fibrosis patients, (mean (± SD) age: 13.8(±12.6)years; mean FEV1: 89(±11)%pred) who were chronically colonized with MRSA, were treated for six months with rifampicin and fusidic acid Two patients had to switch to an alternative protocol, using rifampicin and clindamycin ,due to the resistance pattern of MRSA. Eradication was achieved in all patients even when significant time (range 18 months to 9 years) had elapsed from initial isolation. Side-effects were mild, and did not lead to therapy cessation. Demographic features Genotype Year of first isolate carrier CFRD Pancreas sufficient pseudomonas aeruginosa colonization FEV1%pred F508del/F508del 2007 0 0 0 1 88 F508del/F508del 2010 1 0 0 1 98 F508del/F508del 2004 1 1 0 1 75 S1255P/F508del 2007 1 0 0 0 90 F508del/F508del 2008 1 0 0 1 100 F508del/F508del 2008 1 1 0 1 100 F508del/F508del 2006 1 0 0 1 100 F508del/R553X 2010 0 0 0 1 86 S1251N/L927P 2011 0 0 0 0 NA R1162X/F508del 2011 0 0 0 0 78 S1255P/F508del 2011 1 1 0 0