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.