Mucoid <i>Staphylococcus aureus</i> : A Clinical Trial of Its Prevalence and Association with Lung Function in People with Cystic Fibrosis
<b>Rationale:</b> The mucoid phenotype of <i>Staphylococcus aureus</i> is caused by adaptation. Excessive biofilm formation associated with a protective effect for mucoid <i>S. aureus</i> was observed in isolates from respiratory samples of people with cystic fibrosis (pwCF). <b>Objectives:</b> There is little knowledge about the prevalence of mucoid <i>S. aureus</i> in pwCF and a potential association with CF lung disease. <b>Methods:</b> A prospective multicenter study was conducted (cross-sectional and longitudinal). Specimens and case report forms were sent to the central study laboratory for characterization of <i>S. aureus</i> and analysis of clinical parameters. <b>Measurements and Main Results:</b> In the cross-sectional study, in 41 (9.1%) of 451 <i>S. aureus</i>-positive pwCF from 13 CF centers, mucoid <i>S. aureus</i> was cultured. In the longitudinal study, the distribution of <i>CFTR</i> genotypes and the number of pwCF with highly effective modulator therapy and coinfection with <i>Pseudomonas aeruginosa</i> were equivalent in the mucoid group (35 pwCF) versus the control group (only nonmucoid <i>S. aureus</i>; 36 pwCF). Although lung function did not differ between groups as a whole, a subgroup analysis revealed significantly worse lung function for female pwCF with mucoid <i>S. aureus</i> as well as for pwCF if <i>P. aeruginosa</i> coinfection was excluded. <b>Conclusions:</b> In the era of highly effective modulator therapy, worse lung function was associated with female and <i>P. aeruginosa</i>-negative pwCF with mucoid <i>S. aureus</i> compared with pwCF with only nonmucoid <i>S. aureus</i>. Therefore, appropriate culture conditions should be established to detect mucoid <i>S. aureus</i>. Further investigations are needed to elucidate the relationship between mucoid <i>S. aureus</i> and CF lung disease. Clinical trial registered with www.clinicaltrials.gov (NCT04171583).
Authors
- Helge Hebestreit (ORCID: https://orcid.org/0000-0002-9266-7149)
- J. Peters (ORCID: https://orcid.org/0009-0009-6631-4874)
- C.H. Rumpf
- Manfred Ballmann (ORCID: https://orcid.org/0000-0003-4480-1312)
- C. Decker
- Silke van Koningsbruggen-Rietschel
- Ute Graepler-Mainka
- R. Hait
- Sivagurunathan Sutharsan (ORCID: https://orcid.org/0000-0003-4069-4900)
- K. Romme
- Susanne Nährig
- Dennis Görlich (ORCID: https://orcid.org/0000-0002-2574-9419)
- Anne Schlegtendal (ORCID: https://orcid.org/0000-0002-6737-3624)
- B Wollschläger
- Sabine Renner (ORCID: https://orcid.org/0000-0002-9756-099X)
- Barbara C. Kahl (ORCID: https://orcid.org/0000-0001-5155-3383)
- Christina Keßler
- Sibylle Junge (ORCID: https://orcid.org/0000-0001-8850-6177)
- Jörg Große-Onnebrink (ORCID: https://orcid.org/0000-0003-2053-4379)
- Susanne Deiwick
- Tom Schildberg
- Angelika Dübbers
- Florian Stehling (ORCID: https://orcid.org/0000-0002-2417-2048)
- Holger Schültingkemper
- Peter Küster
- Timo Janssen
- Schwartbeck Bianca
- Corinna Czowalla
Institutions
- University of Cologne (DE)
- University of Würzburg (DE)
- Medizinische Hochschule Hannover (DE)
- Hochschule Campus Wien (AT)
- Ruhrlandklinik (DE)
- University Hospital Münster (DE)
- Essen University Hospital (DE)
- University Children's Hospital Tübingen (DE)
- Universitätsklinikum Würzburg (DE)
- Clemenshospital Münster (DE)
- St. Josef-Hospital (DE)
- STZ eyetrial (DE)
- University Hospital in Halle (DE)
- University Hospital Cologne (DE)
- Institute for Medical Informatics and Biostatistics (CH)
- University of Rostock (DE)
- University of Duisburg-Essen (DE)
- Medical University of Vienna (AT)
- University of Tübingen (DE)
- Ludwig-Maximilians-Universität München (DE)
- Ruhr University Bochum (DE)
Publication Details
- Journal
- American Journal of Respiratory and Critical Care Medicine
- Published
- 2025-02-07
- DOI
- https://doi.org/10.1164/rccm.202407-1474oc
- Citations
- 4
- Primary Topic
- Cystic Fibrosis Research Advances
- Type
- article
- Field-Weighted Citation Impact
- 6.07