MRSA baby

Question

Course:
Our baby has had strong cough at the age of 5 months. By doing a blood cell count, an inflammation has been diagnosed in the body. He got antibiotics and after 4 days the cough went away. About 5 weeks later, he got strong diarrhea. After a week the pediatrician did a stool investigation. Nothing had been found. We were told to wait. After another week without improvement our son was admitted to hospital due to loss of fluids. He got infusions.
The diarrhea did not improve and our son did not get any medication, either. Every stool has been investigated. When there was no improvement and he did not get infusions anymore, we were allowed to go. However, MRSA had been found in the last stool. They told us, this would not be a problem, it would go away. It has not been found on the mucosa.
The diarrhea is still as strong as before. I suspect that our son got the germ during his hospital stay. And I found out, that he is indeed very dangerous.
My question would be, how it can be treated. Everybody says, that it will go away on his own and with the germ also the diarrhea will disappear. However, this cannot be true. The whole gut is involved! And as said before, on the mucosa there is no MRSA, this is a bit striking to me.

Answer

Hello,
you report that your son has had a strong cough at the age of 5 months and that he got an antibiotic treatment because of this and that the cough disappeared then after 4 days. About 5 weeks later your son developed strong diarrhea and had to be treated by infusions in the hospital, as a strong loss of fluids occurred.
Just before the discharge of the hospital MRSA had been found in the stool. Your son had been discharged with the information, that the germ would disappear on its own and that you should not worry. After you informed yourself about the germ you are worrying of course and you ask now, what you could do that the germ disappears again.
You ask this question to the expert team for CF, however one cannot conclude from your question, if your son suffers from CF. In order to answer your question comprehensively, this information would indeed be very important.
I will answer your question first of all under the hypothesis, that your son does not suffer from CF. In this case – therefore supposing that your son does not have a chronic disease – one can at first wait and one can expect with a high degree of security, that the immune system of your son can eliminate successfully the germ from the body. You can support this natural elimination by asking your pediatrician to prescribe a preparation with lactic acid for example that could help to build up the normal gut flora in your son.
As long as the MRSA can still be found in the stool of your son, you should follow very strictly the hygienic measures so that this germ cannot be transmitted to other persons, especially not to people with a severe disease, that is accompanied by a weakness of the immune system. If this had not been done so far, please inform yourself at your pediatrician.
In case your son suffers from CF, then this colonization of the gut is not so unproblematic. There is the hope, that his immune system will cope with the germ alone in the long runs however also in this situation a lactic acid preparation should be used for support. In this case, it should be paid attention to that the germ is not transmitted to the airways, by following hygienic measures. Should the germ still be found in the stool after 8-12 weeks with the mentioned measures, it should be discussed with the physicians of your CF center, if one should try to eliminate the germ by an invasive antibiotic therapy. We wish you and your son all the best.
Best regards,
Dr. H.-G. Posselt

28.07.2015