Tuesday, February 7, 2012

Question by Reader: MRSA

Got this question a few weeks back and I figured that many of you could relate:

Question: My son is 17 months old and swabbed for mrsa at his 15 month visit. We did 6 weeks of bacterum, 2 wks of rifampin, a body wash and nasal cream and his mrsa did not go away. We are especially clean and practice great handwashing. I'm blessed to be a stay at home mother so I have the extra time to be extra clean. I know some things are obviously out of my hands though. Anyway, he hasn't had ANY lung issues in life. I'm very nervous about the mrsa and the nurses and doctors just kind of say they don't know if it is bad or not and not to worry because he's healthy right now. If you know any solid information on mrsa and the fact that he's never had any symptoms but obviously carries it, please let me know. You don't have to sugar coat or hold anything back. I just am not sure what lies ahead, but I suppose we never are sure. I will appreciate any info or advice you have. Also, the doctors said they will not try to get rid of the mrsa again. They say they give it one good shot and then leave it alone. Do you think this is a good idea or should I push for something else?

So what do I know about MRSA? I've had it since about 2004. My lung function is just as high now as it was then. I have had increased hospitalizations, but that could be a result of age and a variety of other factors. I must also note that my hospital stays have shortened since recommitting to treatments and exercise - 3/4 treatments a day plus 1 hour of exercise.

Most doctors in the US only aggressively treat MRSA if symptoms are present. I say US doctors as doctors in Europe are more concerned with MRSA then they are pseudomonas. Our doctors here on the other had aggressively treat pseudo and not MRSA. I'm guessing the difference has to do with the interpretation of different studies.

Anyway, my doctors took the same approach. They aggressively treated it at first, but as it continued to show up, they backed off. My recommendation would be to aggressively treat it for a couple more rounds and see what happens. Chances are that it is here to stay, but you never know. I think regret will always come with not treating something rather then treating it and it still being there. Does that make sense?

Like I said however, what's most important is how he is feeling. Now, at 17 months old, that may be a bit tough to tell, but be sure to pay attention to his symptoms. 

I'm a bit surprised that they don't have you doing any nebs. If anything, it could get him used to what is to come. CPT may be more effective if it is preceded by some albuterol to open him up. With that said however, it may not be needed.

SO HAPPY to hear that thus far there doesn't seem to be much lung involvement! 

It sounds to me like you are doing a fantastic job with your son's care. Don't stress out about these various bugs. Some will happen, some will not. It is not a reflection on how "clean" you guys are or whether or not you wash your hands 100 times a day.