ANTIBIOTIC TREATMENT OF STAPHYLOCOCCUS AUREUS INFECTION IN CYSTIC FIBROSIS

Abstract

During the period 1965-79 191 cystic fibrosis patients have been treated with 2349 course of anti-staphylococcal chemotherapy in the Danish Cystic Fibrosis Centre. The standard treatment was orally administered Fusidic acid in combination with Oxacillin or Dicloxacillin given for 14 days. In cases of penicillin allergy Fusidic acid in combination with Rifampicin was given. The overall results showed that S. aureus was eradicated from sputum by a single course of chemotherapy in 74% of the cases, although in 8% the original strains (phage-type) was replaced by a new strain. Repeated or extended treatment was successful in most of the remaining cases and, as a result, only 9% of our patients harboured S. aureus continuously for 6 months or more. On the average each patient received 2 anti-staphylococcal treatment per year, but no decrease in efficacy of repeated treatment was seen. Likewise, no significant increase of S. aureus precipitins and no development of resistant strains was seen in our patients. Due to the efficacy of chemotherapy and the principles of early treatment whether there are clinical symptoms of infection or not, S. aureus infection is now considered a minor problem without relation to poor prognosis in our cystic fibrosis patients.

Newborn Cystic Fibrosis Pigs Have a Blunted Early Response to an Inflammatory Stimulus

“…We selected S. aureus as a proinflammatory stimulus because it is a frequent pathogen in people with CF, particularly during the first decade of life (14). In addition, S. aureus frequently infects the airways of CF pigs (4).…”

Post-Transcriptional Regulation of Cystic Fibrosis Transmembrane Conductance Regulator Expression and Function by MicroRNAs

“…We observed a significant increase in miR-509-3p and miR-494 expression in both cell types ( Figure 3A). S. aureus is a frequent pathogen in patients with CF, particularly during the first decade of life (29). Whereas S. aureus may elicit innate immune responses through multiple mechanisms, the increased expression of miR-509-3p and miR-494 was notable and raises questions about how complex infectious stimuli may alter CFTR expression in the airways.…”

Microbiology of airway disease in patients with cystic fibrosis

“…Antistaphylococcal beta-lactams including nafcillin, oxacillin, and dicloxacillin have played a major role in controlling S. aureus infections in this population (12,127,182). In Europe, fusidic acid has also been used successfully to treat S. aureus infections (182). Long-term prophylaxis with trimethoprim-sulfamethoxazole (TMP-SMX), dicloxacillin, tetracyclines, and firstgeneration cephalosporins has some efficacy in suppressing S. aureus (12,115,127).…”

“…Work on the pathogenesis of S. aureus-associated lung disease in patients with CF may have been somewhat limited because of the efficacy of antistaphylococcal therapy. Antistaphylococcal beta-lactams including nafcillin, oxacillin, and dicloxacillin have played a major role in controlling S. aureus infections in this population (12,127,182). In Europe, fusidic acid has also been used successfully to treat S. aureus infections (182).…”