Methicillin resistance and vancomycin heteroresistance in Staphylococcus aureus in cystic fibrosis patients

  • V. Cafiso
  • T. Bertuccio
  • D. Spina
  • F. Campanile
  • D. Bongiorno
  • M. Santagati
  • A. Sciacca
  • C. Sciuto
  • S. StefaniEmail author


Methicillin-resistant Staphylococcus aureus (MRSA) infections are increasingly being reported among cystic fibrosis (CF) populations worldwide. In this paper, we sought to examine at the epidemiology, the molecular characterisation and the antibiotic resistance of MRSA isolates in our cohort of CF patients. All MRSA strains were collected prospectively at the University Hospital of Catania, Italy, during a two-year study between mid 2005 to mid 2007 and underwent molecular, pathotype and susceptibility characterisations. Our study demonstrates persisting infections with both hospital-associated (HA-) and community-associated (CA-)MRSA, including Panton–Valentine leukocidin (PVL)-positive strains, in our CF population with an overall prevalence of 7.8%. We demonstrated that, in these patients, persistence was sustained by either identical clones that underwent subtle changes in their toxin content or by different clones over time. The isolation of MRSA in our CF population aged 7–24 years was associated with an increased severity of the disease even if, due to the small sample of patients included and the paucity of data on the clinical outcome, these results cannot be conclusive. Furthermore, three strains were heteroresistant vancomycin-intermediate S. aureus (hVISA), questioning the use of glycopeptides in the treatment of MRSA infections in these patients.


Cystic Fibrosis Cystic Fibrosis Patient Daptomycin Tigecycline Capsular Type 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We gratefully acknowledge the Network on Antimicrobial Resistance in Staphylococcus aureus (NARSA) for providing the Mu3 (NRS2) and Mu50 (NRS1) control strains and Antony Bridgewood for the language revision of the manuscript. Partial support for this study was provided by grants from the Italian Minister of Health and from MIUR-Cofin 2007, 2007SCA9RK.


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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • V. Cafiso
    • 1
  • T. Bertuccio
    • 1
  • D. Spina
    • 1
  • F. Campanile
    • 1
  • D. Bongiorno
    • 1
  • M. Santagati
    • 1
  • A. Sciacca
    • 1
    • 2
  • C. Sciuto
    • 3
  • S. Stefani
    • 1
    Email author
  1. 1.Department of MicrobiologyUniversity of CataniaCataniaItaly
  2. 2.University Hospital of CataniaCataniaItaly
  3. 3.Paediatric DepartmentUniversity Hospital of CataniaCataniaItaly

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