Convalescent care with MRSA

Question

How do I get convalescent treatment despite the suffering from MRSA?

My nine years old daughter has CF, PSA probably since she was born, MRSA since two years.

We, the parents, are physically and mentally down, our nine years old is overstrained by this situation and her school marks have deteriorated, our little one (7 years old) is suffering from pyrosis, fear of loss, nightmares, etc.

We have been advised against going to the Black Sea in order to avoid further colonizations! SOS we need a “time out” urgently.

Answer

Dear parents,

Unfortunately, your daughter has been diagnosed with MRSA (Methicillin resistant Staphylokokkus aureus).
As the frequency of detecting this germ worldwide increases and finding an effective therapy regimen turns out to be more and more difficult due to multiresistance, one should try as a rule to eradicate the germ the first time it can be detected in a patient. Some centers have experienced good success in long-term eradication. However, in our center in collogne (Germany) we only treat this germ if it causes specific problems, e.g. a deterioration of the clinical situation which is not always the case. Some reasons for this are that eradication
therapy is complex and not always successful, and sometimes life circumstances make a successful and longterm eradication impossible (e.g. another family member is carrier of MRSA because of permanent contact to potential carriers of MRSA while working in an old people's home, for example).

In order to avoid infection of other patients, special hygienic provisions have to be made, that you probably know from your visits to the outpatient department (strict segregation of patients, white coat, breathing protection, gloves, etc.). This is the reason why you cannot get a convalescent treatment in a German rehabilitation center for a person suffering from this germ.

There is the possibility to try to get rid of the MRSA germ through antibiotic treatment. In most cases, this requires several antibiotic treatments, nose salves, strict disinfection measures; in other words it is quite extensive and not always successful. Only if MRSA cannot be detected in three consecutive smears taken after the treatment, a stay at a rehabilitation center will be possible.

At the Dead Sea (not: Black Sea) there is an in-patient rehabilitation measure for Cystic Fibrosis, that offers special dates for MRSA patients (see internet (German website): www.cfi-aktiv.de ; then, click on "Klimatherapie" on the right hand side). However, it has to be clarified in advance if or to what extent the health insurance would cover the treatment costs; and also to what extent hygienic measures are applied there for the protection of your daughter.

Regarding the MRSA colonization I can advise you to approach again your CF out-patient doctor and to discuss the mentioned possibilities. Furthermore, I also like to recommend a psychosocial/psychological consultation, which will surely be offered by your CF ambulance, in order to deal with the described strains.

All the best,
S. van Koningsbruggen

13.10.2008