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Canadian Journal of Infectious Diseases
Volume 6, Issue 2, Pages 97-101
http://dx.doi.org/10.1155/1995/176396
Case Report

Eradication of Methicillin-Resistant Staphylococcus Aureus from the Lower Respiratory Tract of Patients with Cystic Fibrosis

David R Burdge,3 EM Nakielna,1,2 and MA Noble3

1Division of Infectious Diseases, Vancouver Hospital and Health Sciences Centre, Canada
2Division of Respiratory Medicine, St Paul’s Hospital, Canada
3Division of Medical Microbiology, The University of British Columbia, Vancouver, British Columbia, Canada

Received 19 April 1994; Accepted 22 June 1994

Copyright © 1995 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Two of 95 patients followed in an adult cystic fibrosis clinic consistently grew methicillin-resistant Staphylococcus aureus (mrsa) on sputum culture. Sputum Gram stain consistently showed +4 polymorphonuclear leukocytes and +4 Gram-positive cocci in clusters. Both patients were co-infected with Pseudomonas aeruginosa and required multiple hospitalizations for treatment of pulmonary exacerbation, resulting in significant infection control concerns. Multiple courses of antibiotics, including ciprofloxacin and clindamycin regimens, failed to eliminate the mrsa. A combination of oral rifampin and clindamycin was successful in eradicating the organism from both patients. Over a 12-month period following therapy, in both patients none of 13 sputums showed Gram-positive cocci in clusters on Gram stain and none of 13 sputum cultures grew mrsa. Successful eradication of mrsa has greatly simplified infection control measures on subsequent hospitalizations, reducing costs and enhancing patient comfort.