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Recurring impetigo?


4KookieKids
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Dd5 has had impetigo on her face about four times in the last ten months. We treat it with bactroban and some essential oils (just to speed up the process), she's clear for a few months, and then it comes back again. We don't do daycare, we homeschool, and we don't know anyone who has had it recently. I just have no idea where it's coming from!! Any ideas?? It's always in the same spot right around her nose and then spreads to her cheeks and chin and upper lip area. We've taken bedding and stuffed loveys and washed/dried on hot and then lysoled them, even.

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My ds has had it three or four times over his lifespan though not in such a short time.  The dr though he was most likely a carrier (about 30pc of people are) where the germ is living in the nose and so if you get a bug bite or cut it breaks out again.  

The doctor didn’t say this but I’ve noticed that it always occurs when his seasonal allergies flare up so I tend to suspect it’s a sign of an immune system that’s already malfunctioning that lets it start running wild.

you might want to get a swab done to make sure it’s not the methicillin resistant type though if it’s clearing up with Bactoban I’m guessing it’s not?

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12 minutes ago, Ausmumof3 said:

My ds has had it three or four times over his lifespan though not in such a short time.  The dr though he was most likely a carrier (about 30pc of people are) where the germ is living in the nose and so if you get a bug bite or cut it breaks out again.  

The doctor didn’t say this but I’ve noticed that it always occurs when his seasonal allergies flare up so I tend to suspect it’s a sign of an immune system that’s already malfunctioning that lets it start running wild.

you might want to get a swab done to make sure it’s not the methicillin resistant type though if it’s clearing up with Bactoban I’m guessing it’s not?

Yes, it clears up within 3-4 days of starting the bactroban every single time (though we still finish the full 7 day regimen). I didn't know you could be a carrier... That's interesting information. DH is about to lysol everything in her room tomorrow and just keep her out for the day and air it out later, hoping that if it's living on any surfaces, that will kill it! I'm not a fan of lysol, but we're just not sure what else to do! We have three other kids, and it's so contagious! She wasn't my first kid to get it - but she's my first to get it more than once ever, let alone in the course of just a few months each time.

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1 hour ago, Ausmumof3 said:

My ds has had it three or four times over his lifespan though not in such a short time.  The dr though he was most likely a carrier (about 30pc of people are) where the germ is living in the nose and so if you get a bug bite or cut it breaks out again.  

The doctor didn’t say this but I’ve noticed that it always occurs when his seasonal allergies flare up so I tend to suspect it’s a sign of an immune system that’s already malfunctioning that lets it start running wild.

you might want to get a swab done to make sure it’s not the methicillin resistant type though if it’s clearing up with Bactoban I’m guessing it’s not?

I was going to say the same thing — our oldest had MRSA misdiagnosed as impetigo when he was 2 years old... It took about four months before it was diagnosed accurately.  The bactoban seemed to help temporarily but it never kicked it entirely.  Once it was accurately diagnosed and we went through the children’s hospital protocol (including the rest of us in the house being treated with the nose antibiotics) it went away and didn’t come back.

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4 hours ago, UnionJack said:

I was going to say the same thing — our oldest had MRSA misdiagnosed as impetigo when he was 2 years old... It took about four months before it was diagnosed accurately.  The bactoban seemed to help temporarily but it never kicked it entirely.  Once it was accurately diagnosed and we went through the children’s hospital protocol (including the rest of us in the house being treated with the nose antibiotics) it went away and didn’t come back.

MRSA is a type of staph, and impetigo is just a term for a rash caused by a staph infection. So if it was MRSA it was still impetigo, if that makes sense. Just a drug resistant strain. 

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3 minutes ago, Ktgrok said:

MRSA is a type of staph, and impetigo is just a term for a rash caused by a staph infection. So if it was MRSA it was still impetigo, if that makes sense. Just a drug resistant strain. 

Yes this!  They are all staph just a variety that’s resistant to the normal antibiotics that get prescribed or at least that’s how the doc explained it. 

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3 hours ago, 4KookieKids said:

Oi. I'd never even thought of this. So if we're on another round of bactroban, can they still swab it to see if it's MRSA, or would I need to wait until/if it comes back again after this round. My hubby is lysoling everything in sight right now.... lol.

MRSA is just staph that is resistant to certain drugs. You said that the impetigo responds well to the drug you are using so that isn’t an issue.

im wondering if your DD has eczema or sebborhea in the crease by her nose, leading to broken skin which allows the bacteria to take hold?

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1 hour ago, Ktgrok said:

MRSA is just staph that is resistant to certain drugs. You said that the impetigo responds well to the drug you are using so that isn’t an issue.

im wondering if your DD has eczema or sebborhea in the crease by her nose, leading to broken skin which allows the bacteria to take hold?

 

Or if she picks up the cat too often and gets scratched a lot while trying to bury her face in his fur... lol.

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If it's MRSA, you might want to look up specific information about what MRSA lives on and for how long.

Prevention/not spreading--bleach water baths (they sound terrible, but they are not harsh) or Hibiclens are great. For surfaces, you have to read the label, see if it kills MRSA, and then follow the directions (surprisingly--many people don't read cleaning product directions, lol!). Many things need to be wiped thoroughly, then you use the cleaning agent, and then you let it sit undisturbed for some time (often ten minutes or more). 

IIRC, besides bleach (which I hate using--I put holes in my clothes when I try), rubbing alcohol used after an initial surface cleaning kills lots of things. I didn't check the list to see if it's on there though.

https://www.uwsuper.edu/shcs/upload/mrsa-at-home-care.pdf

A relative that works in healthcare says that people often pass this around the office--lots of people come in (usually with an actual boil) and think they have some kind of infection that's an occupational hazard. We live in a MRSA hotspot though.

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Hi, just to clarify, impetigo is caused by either staph aureus or strep pyogenes. Since the lesions start to crop up around the nostrils, I would assume that DD5 has intranasal colonization of one of those bacteria. Intranasal Bactroban will get rid of it - talk to your ped. They may recommend everyone in the family use it to make sure you don’t keep passing it around.

As for the question - is it MRSA vs MSSA, MRSA is methicillin resistant staph aureus and MSSA is methicillin sensitive staph aureus. Methicillin is in the penicillin family, so MRSA is resistant to penicillins, like ampicillin and amoxicillin. Penicillins are very powerful cidal antibiotics which mean they kill bacteria. MRSA is feared because we have to treat it with static antibiotics, which only inhibit growth but do not kill the bacteria.

That said, MRSA is not resistant to bactroban, but it is not recommended to use it more than 10 days in a row so that you don’t develop the really dreaded mupirocin resistant Staph aureus. So if it is responding to mupirocin, that doesn’t mean it isn’t MRSA. I would ask your ped until they give you a different approach, because your DD5 somehow keeps reinfecting herself. 

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On ‎9‎/‎23‎/‎2018 at 8:29 PM, Ktgrok said:

MRSA is a type of staph, and impetigo is just a term for a rash caused by a staph infection. So if it was MRSA it was still impetigo, if that makes sense. Just a drug resistant strain. 

Ah, I hadn't realized that!  Thanks for the clarification!

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