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How do we get rid of MRSA?

Our daughter, one year old, CF, has been MRSA positive on and off (sometimes negative, but immediately after positive again) since a hospital stay about six months ago. My husband and I are MRSA negative.

When my daughter was initially colonized, she was diagnosed with MRSA-induced pneumonia. This was treated with a strong antibiotic, which did help to get rid of the pneumonia, but not the MRSA.

When she was admitted again later, this time with bronchitis, the doctors again attempted to tackle the MRSA with antibiotics. Unfortunately, this did not last very long.

We have been at home for some time now (a good three months now) and were told that she would hopefully get rid of the germ here through her immune system. Unfortunately, this is still not the case.

What is your advice? What else can we do? Of course, I am doing a lot of disinfecting in the house; everybody always disinfects their hands anyway. The laundry, etc. as well.

Are there only i.v. antibiotics therapies, or also oral drugs that one could at least try?

In my opinion, it gets more difficult to get rid of the germ the longer one has had it. Therefore it is very important to me to keep battling it. We would very much like to go to a medical rehabilitation clinic at the end of next year to learn a bit more about the disease, to make the food more palatable to my daughter, etc.

Is there any chance at all? Is it possible for a germ to disappear just like that, after a year or so, without doing anything about it?

I am at a loss! Unfortunately, our CF clinic somehow is not doing anything in this direction anymore.

you are reporting that your daughter, who is now 12 months old, has been colonized with MRSA in the lungs since she was 6 months old. You are implying that your daughter might possibly have caught the germ during a hospital stay and that the infection was detected in the context of a then existing lung infection.

In the meantime, there have been two attempts to eliminate the germ through intensive antibiotics therapy. The germ, however, could be traced again after a short interval each time. The treating doctors how suggested to stay observant for some time now and to see whether your daughter’s immune system could defeat the germ.

You are asking whether there are also antibiotics that are effective against MRSA and do not have to be administered intravenously.

After two completed intravenous therapies I, too, would suggest you stay observant for now. It has indeed been observed time and again that MRSA is suddenly no longer detectable even without a targeted therapy. You should not give up hope and just keep waiting as long as your child’s lung situation remains stable.

There are drugs that are effective against MRSA and can be administered orally. One of these drugs has not been approved for children under six years of age and is not on the market in Germany. Your CF doctor is welcome to get more information on this drug via the ECORN-CF expert advice.

Before making another treatment attempt, you should think again about whether all infection paths have been checked. You are saying that MRSA was not found either in you or your husband. However, you should also consider other routes of transmission such as:
- grandparents who live in a retirement home,
- friends and relatives with flaky skin / skin lesions,
- pets can be MRSA carriers as well.

It is important to accompany a further therapy with a treatment with nasal ointment and with washing the skin according to common hygiene standards, and that you disinfect intensively all toys, clothes, bedding and the surfaces of tables and other furniture that your child touched. You should get advice on this from the hygiene expert at your local CF centre.

Unfortunately, your daughter cannot participate in any rehabilitation measure as long as she is colonized with MRSA. Maybe you could make do for the time being with sharing experiences with other parents in your regional self-help group. And perhaps the medical rehabilitation clinic can wait for some time.

We wish you good luck!
Dr. H.-G. Posselt