MRSA Questions

[ReneeP]

Hi everyone...I was wondering if someone could give me some info on MRSA, please. That's one of the CF related things I don't know much about and have several questions...

1.) What exactly is it? I mean, is it a certain type of staph or is it something that develops after a person has had staph for a long time? Does someone catch MRSA or is it just staph at first and then becomes resistant to antibiotics and then becomes MRSA?

2.) How exactly do CF patients get it? Direct contact with mucus only or is it airborne? How easily is it contracted? If a person with MRSA and a CF patient without it are in the same room, what are the chances of it being transferred, 10%, 50%, 99%?

3.) Do only CF patients get it?

4.) Is it ever treatable or is it once there always there?

5.) How bad is it to have? I'm sure it isn't good, but is it life changing?

6.) How long would it take to show up on a culture once the patient has been exposed?


I'm sorry for all the questions, but I'm really stressing out about this issue and need to know....if you can answer any or all my questions, I'd greatly appreciate it. My daughter with CF was exposed to a CF patient with it and I'm scared...

Thank you!

 

[NoExcuses]

1. It stands for Methacilin Resistant Staph Aureus. It is a bacteria that is resistant to a certain class of antibiotics. It is something that bacteria can develop into after a lot of exposure ot antibiotics but it's also something that is community - acquired. A few years ago it used to be just hospital-based patients got it, but now even healthy people can get MRSA.

2. CF patients get it just like they get PA or the cold virus or influenze. If someone sneezes, and the CF patient is near, and it gets in contract with their nose or mouth, a CF person can get the MRSA. MRSA can survive on things like door nobs, arms of chairs, pens, desks, etc for a good amount of time. So if a person with MRSA coughs, covers their mouth with the cough, then touches a pen or a door nob or a arm of a chair, then your CF touches that item and then sticks their fingers in their mouth or nose, they can get the MRSA.

3. Not only CF patients get it. Patients with no respiratory problems at all can get it.

4. You can treat the MRSA. But because CF lungs are so filled with mucus and because cilia don't work effectively to move infection out of the lungs, most likely the CF pateint will be colonized forever. But not always.

5. No new bacteria is good. It's more difficult to treat than Staph Aureus that is susept to Methacilin. But it's not the end of the world.

6. Being colonized with bacteria once properly exposed can be almost instant. Bacteria multiply exponentially so detection should be able to be done fairly soon. But remember how in-exact sputum cultures can be. If the MRSA is hanging out in the lower left lobe, and your child is coughing up phlem from the top right lobe, the sputum won't show the MRSA.


Hope this helps. Please post if you have more questions.

 

[ReneeP]

Wow, Amy...that was quick...and you answered all of my questions...Thank you. I'm freaking out about it and just needed some info to try to absorb the situation and determine how bad it is. Thank you very much.

 

[Alyssa]

Yes, Amy did a wonderful job of answering all your questions !!!

Renee, what happened? Did your girls culture MRSA recently?

My daughter has cultured MRSA and is one of the few who was able to get rid of it. Actually she cultured it before we knew she had CF (she was 13 years old) the infectious disease doc we were seeing at the time was able to treat her with a combination of oral drugs (she is also allergic to sulfa, so he said he was further limited by what he could choose) but she cleared it and has never cultured it since that was almost exactly 5 years ago.

Also one year ago she cultured non-mucoid pseudomonas and it has not returned yet either.... knock on wood

 

[tammykrumrey]

Renee,<br>
I have two daughters with CF.  Kayla is 8 and Hannah is almost
7.  Both girls cultured MRSA about two years ago, and had no
problems with it.  We did not treat it because they were
showing no symptoms of it causing any problems.  After about a
year, Hannah stopped culturing it, but Kayla was still positive.
 This past May she started having a terrible cough which was
keeping her up at night and causing her a lot of issues.  She
was admitted for her first hospital stay due to a lung infection
(has had others, but due to rectal prolapses).  They really
expected to find her culturing PA or something because her x-rays
were bad and her PFT's had dropped from 98% to 62% in one month.
 But the only thing that showed up in her culture, once again
was the MRSA!  So they concluded that she went from 'just
culturing it' to being 'infected with it', and since she was having
other symptoms, she was treated for two weeks with an IV cocktail
of Vancomycin, Tobramycin, and Ceftzidomin.  Her cough is now
is so much better.  Probably better than it has been in over a
year.  She doesn't go back to CF clinic until Sept., so I
won't know until then if the MRSA is gone.  But any symptoms
are, so that is good news.  But once again, my younger
daughter doesn't culture it at all, and they are always sneezing on
each other, and eating or drinking after each other, and they sleep
together half the time.<br>
<br>
Just don't get too stressed out.  You can only do what you can
to protect them from all the little bugs out there.  I have a
nephew with CF, and my sister and I keep our kids apart from one
another.  My nephew(15 yrs old) cultures everything,
MRSA, PA and B. Cepacia and who knows what else!  So there is
no close contact among them at all, and my girls and my nephew know
that they must stay away from one another and to keep distance from
any other kids at CFF events.  I explain to them that they can
play with the friends they know, but any other children they have
to stay at least 10 steps away from them just in case they have CF
and so they don't catch each others 'colds'.  I truly feel
blessed that we made it 8 years without any lung infections that
needed IV treatment.  It seems so many have it much worst.<br>
<br>
Good luck!<br>
Tammy<br>

 

[coltsfan715]

Renee,

I cultured MRSA about 8 yrs ago when I was 16. I was put on Bactrim at first one month on one month off, in labs bactrim has been shown to be effective against MRSA. Unfortunately it is not as effective in the human body. I personally think it mainly kept the MRSA in check so to speak. It never eradicated it, it just kept it from getting out of hand. Once I changed to adult care my doctor started using IV zyvox and Vancomycin to treat it. He also took me off of the Bactrim.
After having cultured MRSA for 8 years I just had a culture my last hospitalization that showed I no longer had MRSA - I still have Staph but it is not classified as MRSA any more. It has become sensitive to more medications. It is normally hard for any bacteria to be completely eradicated once we get it, but it is possible.

For me there hasn't been much of a life change. When they had me taking Vancomycin and Zyvox the meds were stronger so I tended to have more difficulty - with side effects meaning - than I did before. I also tended to worry more initially about the bacteria changing to something that is resistant to everything.

My doctor has told me that it takes MRSA sometimes a week to show up in a culture. If you have it. I am not sure how long it would take for it to show up if you had come in contact with it and caught it that way though. Also I was told that it is possible for it to not show up or be seen in a culture - for example if you have Psuedo as well. Psuedo is a fast spreading bacteria and sometimes it can spread so rapidly that it covers up the growth of any other slower spreading bacteria such as MRSA in this case.

Lindsey