3mrgn

Question

Hello,

A friend of mine works in a domestic nursing service and got in contact with a patient who has this disease. Since then he has been doing badly.
He went to the doctor and they took some samples and sent them to the laboratory, but the results will only be there next Monday.
Can anything happen in the meantime? Can he still be treated afterwards? Does any danger exist?

Answer

Hello,

MRGN means „multi-resistant gram-negative bacillus “. This is a classification of bacteria in relation to antibiotic resistances. The most relevant germ/bacterium in cystic fibrosis is pseudomonas aeruginosa (PA).
For the treatment of PA there are predominantly used four structural classes of antibiotics. If PA (in the usual resistance testing) is merely sensitive to one of these classes, one talks about “3 MRGN”. Is the PA resistant to all four classes, it is called 4MRGN.
These terms were introduced by the commission for hospital hygiene and infection disease prevention (KRINKO) of the Robert Koch institute in 2012 [the original question and answer are posted on the German platform of ECORN-CF].
The microbiological evidence of 3 or 4MRGN in the patient’s material as e.g. the throat swab is not equal to a disease.
It may also be that bacterial pathogens only colonize the skin and the mucosa. As you write in your question, your friend already went to the physician and samples were taken there.
In order to assess this case, the test results are needed.
As there do not exist any clear hints concerning the symptoms that occurred, it is difficult to judge whether there does exist a disease through 3MRGN.
After getting the results your friend can be usually treated by his physician, if it is indicated. Concerning hygienic aspects, the physician will also be able to give further information to your friend.

I hope to have been helpful.
Best regards,
Jörg Steinmann

15.09.2015