Intravenous antibiotics given for 2 weeks do not eradicate persistent Staphylococcus aureus clones in cystic fibrosis patients. (4th November 2013)

• Record Type: Journal Article
• Authors: Andersen, C.; Kahl, B. C.; Olesen, H. V.; Jensen‐Fangel, S.; Nørskov‐Lauritsen, N.; Lina, G.
• Is Part Of: Clinical microbiology and infection. Volume 20:Number 5(2014:May)
• Page Start: O285
• Page End: O291
• Publication Date: 2013-11-04
• Subjects: Medical microbiology -- Periodicals; Diagnostic microbiology -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 616.01
• DOI: 10.1111/1469-0691.12406
• Languages: English
• ISSNs: 1198-743X

Abstract

<abstract abstract-type="main" id="clm12406-abs-0001"> <title>Abstract</title> <p> <italic>Staphylococcus aureus</italic> is the most commonly isolated pathogen in respiratory tract secretions from young patients with cystic fibrosis (CF), and several treatment strategies are used to control the infection. However, it is not known whether intensified treatment with antimicrobial agents causes eradication of <italic>S. aureus</italic> clones. We retrospectively determined the impact of intravenous (IV) antimicrobial agents on the suppression and eradication of <italic>S. aureus</italic> clones. One thousand and sixty‐one <italic>S. aureus</italic> isolates cultured from 2526 samples from 130 CF patients during a 2‐year study period were subjected to <italic>spa</italic> typing. Intervals between positive samples and the occurrence of clone replacements were calculated in relation to courses of IV antimicrobial agents. Of 65 patients chronically infected with <italic>S. aureus</italic>, 37 received 139 courses of IV antimicrobial agents with activity against <italic>S. aureus</italic> (mean duration, 15 days; range, 6–31 days). Administration of IV antibiotics increased the time to the next sample with growth of <italic>S. aureus</italic>: the mean interval between two positive samples was 68 days if IV treatment had been administered, in contrast to 49 days if no IV treatment had been administered (p 0.003). When <italic>S. aureus</italic> recurred in sputum after IV treatment, the isolate belonged to a different clone in 33 of 114 (29%) intervals, in comparison with 68 of 232 (29%) intervals where IV treatment had not been prescribed (OR 0.98, 95% CI 0.60–1.61). In conclusion, we show that 2 weeks of IV antimicrobial treatment can significantly suppress chronic staphylococcal infection in CF, but is not associated with the eradication of persistent bacterial clones.</p> </abstract>