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MRSA transmission

If a CF patient is culturing MRSA, how high is the risk of transmitting MRSA to a partner(without cf) through kissing and sexual activity?
Dear Questioner

Staphylococcus aureus is a type of bacteria that is commonly found living on the body surfaces of many people- it can colonize the nose, throat, armpits and other body areas without causing disease. In recent years, S.aureus has been identified which is resistant to many types of antibiotics which would commonly be used to treat infections, and this is called Meticillin resistant S. aureus (MRSA). MRSA is found only rarely among people in outside hospitals- however, it can spread rapidly within healthcare settings or in cases where people live and have close contact with each other. In most cases, acquiring MRSA probably won’t result in disease in that individual. However, if the person has a wound, or other skin breaks, or has an underlying medical condition that might make them more likely to pick up infections, it could cause a serious infection.

It is possible for people who have MRSA (CF or non-CF) to pass it to household contacts or to people with whom they have close contact- even pets!- and recent studies have suggested that MRSA can be spread from the respiratory tract by coughing, sneezing and kissing. Partners of people with MRSA are at increased risk of transmission, probably because of increased bodily contact1. However, unless those contacts have a medical condition, its not likely that they would develop an infection but there is a chance that they become colonized with MRSA. This colonization may well be short-lived, but might be long enough to pass it back to the person with CF- this is particularly a problem if the person with CF is undergoing decolonization (i.e. a course of antibiotics designed to get rid of the MRSA).

In order to avoid a cycle of colonization being established, it would be important to consider some important, but simple, infection control measures2. Regular showering using a medicated wash, containing chlorhexidine and handwashing, particularly after coughing or sneezing, by all household contacts may reduce the risk of colonization- alcohol based hand rubs may be particularly useful in this case. In addition, regular changing of bed linen and bed clothes may cut down the risk of MRSA spread.

Dr Deirdre Gilpin
Prof Stuart Elborn
CF & Airways Microbiology Research Group

1Mollema et al. Transmission of Methicillin-resistant Staphylococcus aureus to household contacts. J. Clin. Micro. 2010: 48 (1); 202-207
2 Saiman & Siegel. Infection control in Cystic Fibrosis. Clin Micro Rev. 2004: 17(1); 57-71
The answer is edited by: Prof Stuart Elborn