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MRSA?

Question
Coagulase-negative staphylococci (methilcill.resist) were detected in the sputum of my 6 year old daughter (I transcribed this – I heard it for the first time!).
Now, I read in your forum that these pathogens give cause for concern.
In addition to Zithromax®/acithromycine (she takes 250ml every second day) my girl has to take the antibiotic Bactrim® (Trimethoprim and Sulfamethoxazole or short: TMP-SMX) now for eight days (2 x 6ml). Does this settle the matter or do we have to expect further complications? Actually she is doing fine, she goes to school, makes a healthy impression…
Is it MRSA!?!

Answer
Hello,

to begin with let me answer the last part of your question: MRSA are “methicillin-resistant staphylococcus aureus” bacteria which are coagulase-positive and show a certain resistance pattern; this means that your daughter’s methicillin-resistant coagulase-negative staphylococci are not MRSA pathogens. Sometimes they are called MRSE which is a bit an awkward name since it can be mixed up easily.

Many coagulase-negative staphylococci species have been known to be a natural part of the human skin flora for a long time. Neither in patients with CF nor in persons with an intact immune system do these pathogens cause an infection in the respiratory tract because they have a low disease causing potential. Therefore, it is not necessary to do a therapy if there is a proof from the respiratory tract. The patients do not have to be segregated either! Generally speaking, these germs primarly play a role in the environment of a hospital, e.g. by causing a catheter infection.

In your daughter’s case the findings are harmless; unfortunately they were obviously not interpreted correctly. Please contact again the attending physicians at your CF center so that the therapy can be rechecked and in order to avoid misunderstandings.

We wish you and your daughter good luck and success in this situation.

Best regards,
Prof. Dr. Barbara Kahl and Dr. Daniela d’Alquen
15.11.2010