Materials and Methods
This was a single-center retrospective study conducted at the Marmara University Medical Faculty Selim Çöremen CF Center between January 2015 and December 2019. 309 patients with CF were involved in the study. The inclusion criteria were: CF diagnosis according to the consensus guidelines from the Cystic Fibrosis Foundation18, regular follow-up in the CF center outpatient clinic and having at least 4 sputum or deep pharyngeal swab cultures per year (every 2-4 months).
All sputum and deep pharyngeal swab cultures collected from subjects between 2015-2019 were reviewed. Patients who had their first isolation of P. aeruginosa or MRSA were grouped separately. Patients’ demographics, anthropometric measurements, clinical findings, chest physiotherapy (CPT) techniques, regular treatments and eradication regimens were obtained from the medical records.
Chronic or intermittent infection of P. aeruginosa or MRSA were determined according to the Leeds Criteria19. The Leeds Criteria defines chronic infection as having positive P. aeruginosa or MRSA in more than 50% of the cultures in the preceding year and intermittent infection as having positive P. aeruginosa or MRSA in less than 50%. Successful eradication was set as not having any isolation of P. aeruginosa or MRSA during 12 months after having the eradication regimen for their first isolation. Patients were followed up at least one year after their first isolation of P. aeruginosa or MRSA.
The primary analysis of the study was the comparison of the percentage of successful eradication after receiving IV and non-IV (oral and/or inhalation) eradication regimens. Sex, diagnosis age, age at isolation, body mass index (BMI) z-score, ∆F508 mutation, pancreatic insufficiency, CF-related Diabetes Mellitus (CFRD), biliary-hepatic disease, azithromycin use, dornase-alfa use, inhaled corticosteroid use, allergic bronchopulmonary aspergillosis (ABPA), previousmethicillin-sensitive S. aureus (MSSA), chest physiotherapy and FEV1pp were analyzed as predictors of eradication failure.
The aim of the study was explained and informed consent was obtained from the participants beforehand. The Marmara University Medical Faculty Research Ethics Committee had approved the study with protocol number 09.2020.509.