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Meaning of germs

Question
Dear expert team,
our daughter (5-years old) has CF and until now she is doing well. We just had again the big annual investigation at our center (lung function 106%). The result of the throat swab was the following:
Moraxella catarrahlis
Klebsiella oxytoca
Staph. aureus
In parallel to the opinion of our center I would like to get a second opinion.

What is the meaning of those germs?
How can one avoid those as possible?
Way of therapy?
Longterm effects?

At the moment, no therapy is done because there is no infection.

How do you judge the colonization with Staph. aureus? Until now, we only took antibiotics during an infection.
Many thanks for your opinion.
Answer
Dear questioner,
the germ Moraxella catarrhalis is frequently found in the throat and can be a cause for airway infections. As long as your daughter does not show any changed symptoms (increased cough, more secretions, fever, weakness) the only finding of the germ has not to be treated.
The germ Klebsiella oxytoca belongs to those germs originating from the bowel and that mostly do not cause chronic infections in CF patients.
About the germ Staphylcoccus aureus (S. aureus) it can be said, that this germ is frequently found in CF patients and often for many years if not to say lifelong. Unfortunately there are no good studies on the efficacy of antibiotic therapies in case of the finding of S. aureus in the airways of the patients. Therefore there are centers, that initiate an antibiotic therapy at any finding of S. aureus, and there are others, that only intiate a therapy if the patients show additional symptoms. And then there are centers, that are giving antibiotics for many years permanently (prophylactically), in order to avoid an infection with S. aureus. Which therapeutic regimen is the best, is unfortunately not clear and therefore different centers treat differently.
As a microbiologist, who is working for a long time on the finding of S. aureus in CF patients, my recommendation would be, to treat only in the case, if new or increased symptoms occur in addition to the finding of S. aureus.
Best regards,
Barbara Kahl
07.02.2015