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How to get rid of MRSA

Our son (6 months old) is permanently struggling with MRSA (in the nose and throat). Currently, he is colonised but he also had an MRSA infection twice; each of them was treated by strong antibiotics. Once, there was a short-term success, once there was no success, respectively, there is currently no infection but the colonisation is still there.

Is it possible at all to get rid of the colonisation at home? How big is the chance?
Is there any oral antibiotics that is effective?
We have been in the hospital six times alltogether and I cannot go on like that any more.

Which measures do your recommend to take?

If I understand your question right, your son is six months old and his nose and throat area is permanently colonised with MRSA (methicillin-resistant Staphylococcus aureus or multidrug-resistant Staph. aureus). Because of acute signs of infection a specific antibiotic therapy against MRSA was performed twice; while the signs of inflammation improved, MRSA has still been detected in the nose and throat zone (nasopharyngeal zone). You report that you were in hospital six times already and that this burden is almost unbearable for you. You ask if MRSA can also be treated by oral antibiotics and if there is a chance at all to eliminate the pathogen.

I do not know the exact anamnesis of your child. It is relatively uncommon that a baby is already infected with MRSA. Therefore, it is very important to find out where your son was infected with MRSA. Did it happen, for example, during a stay in hospital since your son had complications during the first days or weeks of his life? If this is not the case, it should be clarifyied if all family members, who have been in contact with your son to date, have been tested (contact investigation with nasal swab of all persons coming into consideration). This checkup is important for avoiding permanently recurring reinfections.

Generally speaking it is known that infections (or colonisations) with MRSA in CF individuals cannot be treated with success very easily, and often not at all. This means that for some patients the elimination of the germ (pathogen) is impossible. On the other hand it can be observed from time to time that MRSA in a CF individual vanishes by itself because the immune system of the body fought the germ successfully. In your 6-month-old son the immune system is in process of being fully developped. For the time being one could also adopt a wait-and-see attitude and hope that the MRSA disappears by itself. An appropriate treatment of MRSA always has to be performed as a combination of 2 or 3 drugs and for a period of at least 14 days. Generally, the treatment with orally administered antibiotics is possible. Some of these drugs, however, are not authorised for children in the age of 6 months or they are not sold on the German market. [the original question was asked on the German platform of the expert advice] . In case one decides again for an eradication therapy, of course the accompanying therapies with nasal ointment and washing of the skin have to be performed according to the standard of the hospital.
Please see more information on the topic sanitation of the environment in the public comment field.
Best regards,
Dr. H.-G. Posselt
Dr. med. Christian Brandt, the head of the department of hospital hygiene, institute for medical microbiology and hospital hygiene at the university hospital of Frankfurt, Germany answered on a former question about sanitation of MRSA in the environment:
"In case of decolonization of MRSA the germ should not only be treated on/at the body of the human being but in order to avoid recontamination ("ping-pong effect") also in his surroundings. In here it is most important to think of the especially relevant possible reservoirs of MRSA:

1) other human beings should also be investigated (especially in case they have an increased risk of MRSA themselves, like e.g. open legs, exfoliative skin diseases)
2) also pets can be MRSA-carriers, probably contact the veterinarian (however, decolonization of animals is very difficult)
3) the closer the contact to certain things is, the more important is their disinfection: clothes, bedclothes including pillows/inner quilts, cuddly toys are to wash at 60°C

Tooths brushes, combs, cosmetic products, ointments, tubes where appropriate have to be exchanged.
It is wihtout doubt, that during the decolonizing measures very strict cleanness has to be maintained.

If beyond this furhter decolonizing measures are necessary is discussed controversially: carpets, uphlostered furniture are a potential MRSA reservoirs. If this is really relevant remains speculative. Most likely furniture, carpets on which the child plays/lies. Probably a rigorous cleaning is sufficient, for a professional disinfection a disinfector has to be commissioned.

I would not recommend a gazing with formalin of the entire appartment as an ultimative disinfection measure, as I do not consider this necessary.
Dr. med. Christian Brandt"

D. d'Alquen