AUTHOR=Westphal Corinna , Görlich Dennis , Kampmeier Stefanie , Herzog Susann , Braun Nadja , Hitschke Carina , Mellmann Alexander , Peters Georg , Kahl Barbara C. ,  Staphylococcal CF Study Group , Junge. Sibylle , Tümmler. Burkhard , Ellermunter Helmut , Dübbers Angelika , Küster Peter , Ballmann Manfred , Koerner-Rettberg Cordula , Große-Onnebrink Jörg , Heuer Eberhardt , Sextro Wolfgang , G Jochen , Hammermann Jutta , Graepler-Mainka Ute , Staab Doris , Wollschläger Bettina , Schuster Antje , Tegtmeyer Friedrich-Karl , Sutharsan Sivagurunathan , Wald Alexandra 

TITLE=Antibiotic Treatment and Age Are Associated With Staphylococcus aureus Carriage Profiles During Persistence in the Airways of Cystic Fibrosis Patients

JOURNAL=Frontiers in Microbiology

VOLUME=11

YEAR=2020

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2020.00230

DOI=10.3389/fmicb.2020.00230

ISSN=1664-302X

ABSTRACT=<sec><title>Background</title><p><italic>Staphylococcus aureus</italic> is one of the most isolated pathogens from the airways of cystic fibrosis (CF) patients. There is a lack of information about the clonal nature of <italic>S. aureus</italic> cultured from CF patients and their impact on disease. We hypothesized that patients would differ in their clinical status depending on <italic>S. aureus</italic> clonal carriage profiles during persistence.</p></sec><sec><title>Methods</title><p>During a 21-months prospective observational multicenter study (<xref ref-type="bibr" rid="B16">Junge et al., 2016</xref>), 3893 <italic>S. aureus</italic> isolates (nose, oropharynx, and sputa) were cultured from 183 CF patients (16 German centers, 1 Austrian center) and subjected to <italic>spa</italic>-sequence typing to assess clonality. Data were associated to lung function, age, gender, and antibiotic treatment by multivariate regression analysis.</p></sec><sec><title>Results</title><p>Two hundred and sixty-five different <italic>spa</italic>-types were determined with eight prevalent <italic>spa</italic>-types (isolated from more than 10 patients): t084, t091, t008, t015, t002 t012, t364, and t056. We observed different carriage profiles of <italic>spa</italic>-types during the study period: patients being positive with a prevalent <italic>spa</italic>-type, only one, a dominant or related <italic>spa</italic>-type/s. Patients with more antibiotic cycles were more likely to be positive for only one <italic>spa</italic>-type (<italic>p</italic> = 0.005), while older patients were more likely to have related (<italic>p</italic> = 0.006), or dominant <italic>spa</italic>-types (<italic>p</italic> = 0.026). Two percent of isolates were identified as methicillin-resistant <italic>S. aureus</italic> (MRSA) and evidence of transmission of clones within centers was low.</p></sec><sec><title>Conclusion</title><p>There was a significant association of antibiotic therapy and age on <italic>S. aureus</italic> carriage profiles in CF patients indicating that antibiotic therapy prevents acquisition of new clones, while during aging of patients with persisting <italic>S. aureus</italic>, dominant clones were selected and mutations in the <italic>spa-</italic>repeat region accumulated.</p></sec>