WS18.5 MRSA in cystic fibrosis: potential for transmission within CF centres?

Abstract

Introduction: Increased healthcare utilisation in CF patients may be associated with MRSA acquisition. This study aimed to determine (i) the similarity of MRSA isolated from CF and non-CF patients in two centres [University of Washington (UW) and Royal Belfast Hospital for Sick Children (RBHSC)], and (ii) the evidence for shared patient clones, which may indicate transmission. Methods: MRSA isolates from patients in Seattle (n = 71 from 23 paediatric CF patients; n = 20 from non-CF MRSA colonized patients; n = 10 from nonCF respiratory patients; n = 22 from non-CF non-respiratory patients) and Belfast (n = 24 from CF paediatric isolates; n = 11 non-CF paediatric patients; n = 17 non-CF colonized patients) were compared using Pulsed Field Gel Electrophoresis (PFGE). Isolates were considered similar if they possessed >60% homology. Results: Both UW and RBHSC CF and non-CF MRSA isolates formed closely related PFGE groups, regardless of disease background (RBHSC: >70%, UW: >67%). In general, isolates were not regarded as being similar in between-centre comparisons (44%). Sequential isolates from individual UW patients shared a high degree of homology (>90%). Conclusions: CF-MRSA strains were similar to endemic strains in circulation among non-CF patients in the local healthcare setting. The clonal nature of infection observed both within-centre, and in UW sequential paediatric isolates, suggests repeated acquisition from an MRSA reservoir, or more likely, persistence within the patient. This study supports a role for rigorous infection control and development of appropriate eradication strategies to prevent transmission and subsequent colonization/infection of CF patients. WS18.6 Outbreak of Burkholderia contaminans infection in children with cystic fibrosis: short term lung function and nutritional outcome F. Renteria1, S. Massa1, M. Bettiol1, B. Gatti1, V. D’Alessandro1, S. Prates1, E. Segal1, G. Diez1. 1Hospital Sor Ludovica, CF Center, La Plata, Argentina