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Is there another remedy for Staphylococcus Haemolyticus apart from Mometasone nasal saline?

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Have Staphylococcus Haemolyticus infection in my nasal passages. Was told it is incurable & have been put on Mometasone 0.012mg/ml nasal saline in liquid form, which I take twice a day at 25cc-25ml. It, the liquid has been driving me crazy, and I can't take it much longer. Is this really necessary and will I need another operation if I stop taking this? I don't know what to do. XXXXXXX Richter
Posted Mon, 16 Apr 2012 in Ear, Nose and Throat Problems
Answered by Dr. Sumit Bhatti 1 hour later

Thank you for your query.

1. Your resistant Staphylococcus Haemolyticus nasal and sinus infection is probably a nosocomial (hospital acquired) infection. Have you had a culture and antibiotic sensitivity done?

2. The cause of your problems is Biofilm formation in your nasal passages and sinuses. There may be associated allergic, fungal and mucus related conditions. The simplest example of Biofilm is the sludge or slime seen in drainage pipes or the moss seen along water channels. The Biofilm represents colonies of different types of bacteria living together like a 'city' with different micro organisms taking up different tasks or 'profession's like we do in our communities. Some of them secrete a matrix that protects them all. Due to close proximity, these bacteria share genetic material and may be genetically distinct from those that are grown in lab cultures. Hence they do not respond to the same antibiotics that they show sensitivity to in lab studies.

3. Bacteria like Staphylococcus Haemolyticus are notorious for antibiotic resistance and produce toxins. Bacteria like E coli frequently co-exist and can cause other species like staphylococcus to become more resistant by exchange of genes and chemicals.

4. I would like to see any CT Scans that may have been done in the past. You may share them on free file sharing sites such as WWW.WWWW.WW or WWW.WWWW.WW The reason is to see the nasal passages and sinuses. This is because poor ventilation and drainage of your nasal passages and sinuses is the most important cause of Biofilm formation.

5. You should wash your sinuses with a solution of normal saline with a pinch of salt and baking soda added to it. This alkaline nasal douche will help break up the Biofilm and allow penetration by other antibiotics. If Mometasone does not suit you, you may discontinue and replace it with a milder steroid such as fluticasone or ciclesonide. Steroids should be given under antibiotic cover.

6. You may add an antibiotic like tetracycline or chloramphenicol. However this should be done under medical supervision.You should discuss with your treating doctor about trying higher generation antibiotics such as cefprozil, ceftriaxone, vancomycin, teicoplanin, tigecycline or linezolid. You should draw their attention to Biofilm formation, which is a relatively new concept.

7. Supportive treatment such as mucolytics, anti allergics, anti fungals, steam inhalation and dental hygiene should be taken. Surgical debridement, removal and disruption of the Biofulm require surgery.

8. I hope that you do not have any other immune suppressive disorder such as diabetes. In such cases oral steroids are contra-indicated.

Hope I have answered your query. If you have any follow up queries I will be available to answer them.

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