Clinical Interviews

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Dr. Nick: I am director of one of the largest CF programs and I spend about half of my time with clinical care, both in the hospital and the clinic. I have a large research program that is both clinical trials and I have my own lab as well.

Interviewer: On average, how many cystic fibrosis patients would you say are under your direct care?

Dr. Nick: Under my direct care probably about 200.

Interviewer: How many are treated at your center?

Dr. Nick: We have around 600 sign into the registry, but in any one year, we probably see about 450.

Interviewer: Of the patients under your care, what proportion currently has pulmonary MSRA infections?

Dr. Nick: It’s about 30 percent.

Interviewer: What about the proportion that have pseudomonas
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Nick: It’s about 75 percent.

Interviewer: What proportions of the patients with MRSA have Pseudomonas as a co-infection?

Dr. Nick: Nearly all of them, probably 8- percent of the MRSA patients have Pseudomonas as well.

Interviewer: Broadly speaking, how do you tend to think about different categories or sub groups of CF patients with MRSA infections?

Dr. Nick: I guess I am not sure exactly what you are
…show more content…
Nick: It is just really an individual thing and case by case. It is hard to make large generalizations. Again, most of these patients are co-infected with other bacteria.

Interviewer: What do you see is the relative importance of treating the intracellular component of an MRSA infection in addition to the extracellular infection?

Dr. Nick: It is just hard to separate that out. I think most of our airways infections are mostly extracellular in the sense that they are in the lumen of the bronchi. They are not invasive endothelial cells. I really don’t make the distinction usually. I think most of our infections are airway infections.

Interviewer: What about the importance of addressing bacteria biofilms?

Dr. Nick: I think it is a very important issue. We don’t have any specific approach that differs at this time, but if we had one it would be of interest.

Interviewer: Do concerns around antibiotic resistance ever influence your choice of treatment regimen for MRSA?

Dr. Nick: Do you mean about antibiotic resistance that they already have or preventing antibiotic resistance?

Interviewer: Preventing, for example, some people maybe have concerns about the development of resistance against Linezolid, or sort of increasing [inaudible][00:13:58] with

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