Common bacteria in cystic fibrosis

If your child has any of these bacteria they can still go to school or nursery.

Children sometimes come to clinic and have a cough but we do not find any bacteria on their swab samples. We will treat these symptoms with a course of antibiotics.

Sometimes children may come to clinic and have no respiratory symptoms but will have bacteria on their swab samples. We will treat the bacteria with a course of antibiotics.

Staphylococcus aureus (known as S. aureus here after)

Staphylococcus aureus (known as S. aureus here after) is most commonly found on the skin and in the nose. Can cause skin and chest infections.

People with cystic fibrosis can get S. aureus in their lungs at any age and the impact will vary from child to child.

Here at Sheffield Children’s we treat children with a preventative dose of flucloxacillin (antibiotics) from birth to 2 years old to help stop this. See separate information about the CFSTART Study.

If we find S. aureus in your respiratory mucus from a cough or nose swab, then we will increase the dose to 4 times every day, for 4 weeks.

Some more antibiotics, nasal clearance and long term flucloxacillin can be used if the bacterium is grown repeatedly.

From the age of 2 years, this preventative antibiotic will be stopped and only prescribed if the bacteria grows back again.

You can cut down on the chance of getting a S. aureus infection by washing hands and having good personal hygiene such as bathing or showering regularly.

You should give your child flucloxacillin about 1 hour before food or 2 hours after they have eaten. This can be hard with babies. So until your baby is more awake during the day, it is ok to give the antibiotic just before a feed. Once your baby is awake for longer then you can give your child Flucloxacillin as directed.

Methicillin resistant staphylococcus aureus (MRSA)

MRSA is a type of staphylococcus aureus that is resistant to a few widely used antibiotics. This means it can be more difficult to treat than other bacterial infections.

It is less common in people with cystic fibrosis than the S. aureus but it can spread from person to person. It spreads from hand contact. If your child has MRSA then staff if the cystic fibrosis team need to be carful your child does not come into contact with other children.

We treat MRSA with a combination of antibiotics depending on test results from the laboratory.

Haemophilus influenzae

Haemophilus influenzae is common both in people with and without cystic fibrosis. It sits in your nose and throat but does not cause any harm.

It is spread between people by direct contact or by respiratory droplets by coughing and sneezing. It can cause a cough and cold like symptoms but does not have any long term affects.

This bacterium is usually treated with amoxicillin or co-amoxiclav.

Other common bacteria

Moraxella catarrhallis and streptococcus (various types)

These can cause acute infection but probably not long term damage.

They are found in the nose and throat. Depending on the type of bacteria, we treat it with either co-amoxiclav or penicillin.

It is spread by direct contact with contaminated droplets from coughing and sneezing. But it can also live in the upper airway without causing symptoms.

Stenotrophomonas maltophilia (S. maltophilia or SMA)

This bacteria is found in water, soil and plants. Nebuliser equipment may also be contaminated with S. maltophilia.

S. maltophilia does not spread from patient to patient and is unlikely to cause severe infection in people with cystic fibrosis.

If we test your child for this and they have the bacteria and have symptoms like a cough or cold then we will treat it with 4 weeks of co-trimoxazole (also know as Septrin).

If your child does have the bacteria but does not have any symptoms, then we do not treat it.

Nebuliser equipment should be cleaned as directed by the cystic fibrosis physiotherapist.

Burkholderia cepacia (Bcc)

There are a few types of Bcc and people with cystic fibrosis can react to them differently. All types of Bcc are highly resistant to antibiotics.

Some people may experience more chest infections while others may have no symptoms. In rare cases, people may develop pneumonia known as ‘cepacia syndrome’.

Bcc is found in water, soil and rotten onions.

If your child has this bacteria, they will be treated with a course of intravenous (IV) antibiotics. After that, they will be given an oral and nebulised antibiotic for at least 3 months.

Some species of Bcc are spread easily between people. Because of this, children with Bcc need to be looked after separately from other cystic fibrosis children to minimise the risk of the bacteria being passed on. They will be seen in main outpatients. When they are  staying in hospital, they will be admitted to a different ward too.

Non tuberculous mycobacterium (NTM)

There are a few types of NTM people cystic fibrosis can react to it differently.

NTM is found in fresh water, dust, soil and drinking water.

If your child has NTM, which type they have and if they have any other symptoms like a chest infection will depend on how we treat your child. to

Some types of NTM may spread between people so your child will be seen in main outpatients instead, so other children with cystic fibrosis do not come into contact with them.