Ear culture came back MRSA

[Liung]

I’m reeling right now, the pus in Delilah’s ear was cultured and the results came back MRSA. Actual literal MRSA. I’ve been advised to only handle her while wearing gloves, and to not let pregnant or immunodeficient people near her.

How does this HAPPEN to us?! Lahi’s autopsy has come back “yes his cancer has literally never been documented in rabbits before” and now Delilah has freaking MRSA?!

We found she had abscesses in her ears. Started her on Duplocilin injections. Next checkup, ears have gotten worse, scheduled her for PECA-BO surgery on the first ear. Sent pus for culture, culture came back resistant to penicillin. Switched her to a different antibiotic (I think it was azithromycin?), next surgery for the other ear, sent it off for culture, culture came back resistant to that too. Checkup this week, found pus still in her ears, sent that for culture, culture came back MRSA.

Oh my GOD.

I’ve been looking into adopting another rabbit for Delilah, she’s been so lonely since Lahi’s death, she’s actually losing fur from stress. The vet assured me that as long as a new rabbit is healthy it should be fine. Somehow I doubt the rescue group is going to see it that way.

Also, I work in a biosecure medical research facility. This has implications for risking my JOB.

I’m attaching the discharge summary so anyone who wants to can read it. Gonna go beat my head on the wall for a bit.

 

[squidpop]

Have your rabbits been on penicillin and other antibiotics for a very long time? Many people use an antibiotic and it stops working, then they switch to another antibiotic, and another and another, then penicillin on and off for years. I wonder if this could breed MRSA.

 

[Liung]

Have your rabbits been on penicillin and other antibiotics for a very long time?

Timeline:
February 2019 - pus was found in Delilah’s ears and cleaned. They talk to me about the risk of inner ear abscesses due to her being a lop.

August 2019 - I see Delilah scratching at her ears a lot and ducking my hand, take her in for checkup and she now has developed abcessss at the base of her ears, we put her on duplocillin injections

November 2019 - the duplocillin injections failed to manage the abscesses and she had her first culture done during her left ear PECA-BO surgery, which came back staphylococcus aureus and fusobacterium necrophorum, and due to the cultures showing penicillin resistance, we switched her to oral azithromycin.

December 2019 - she had her right ear PECA-BO and the culture came back the same, staphylococcus aureus and fusobacterium necrophorum, this time also resistant to azithromycin. We switch her to oral sulfamethoxazole & trimethoprim.

January 2020 - I take her in to check her ears and get a tooth trim, as well as get her blocked tear ducts looked at. We never do get the tooth trim done because pus is found in her left ear and they want to do a culture. The culture comes back methicillin resistant staphylococcus aureus and staphylococcus simulans. She’s back on the sulfamethoxazole & trimethoprim, which I don’t expect to do much considering she was already on that and pus still happened, and has now been put on oral chloramphenicol.

Chloramphenicol isn’t used in humans because apparently there’s been a couple cases of it causing bone marrow cancer. FUN! I’ve been told that this isn’t a concern for rabbits and it has had a lot of success in veterinary use, but to wear gloves while administering it for my own safety. Also, bizarrely, it smells like birthday cake.

So basically Delilah has had staph aureus from the beginning but I highly doubt that she personally could have managed to mutate it into full blown MRSA all by herself in the space of 5 months. It’s possible, I guess, and considering our luck I’m not ruling it out. But I think more likely that the existing staph aureus just make her a higher risk for contracting the MRSA.

 

[Liung]

Also, this is tragic, I’ve been told to try to only handle her with gloves, and absolutely no kisses.

Delilah LOVES kisses. Kisses is how she says hi, kisses is how she begs for food. SAYING NO TO THIS FACE IS ACTUAL LITERAL TORTURE.

 

[squidpop]

Oh my gosh, there are so many different bacteria involved. She has been through a lot.
No kisses is tragic. Fingers crossed the Chloramphenicol works.

 

[Liung]

Yep, so she’s going to be on chloramphenicol for the next 2 months in the hope that clears it up, and then we’ll probably have to do a CT scan to make sure ($600, ewwww)

My big concern right now is to get the discharge from her blocked tear ducts cultured. If the MRSA is just in her ears, that’s not a huge deal, her ears aren’t leaking everywhere. Practicing good hand hygiene after handling her would likely be fine.

But if it’s in her eyes, she grooms her face and now the MRSA is on her paws, and it’s everywhere she walks. That’s going to be hard to manage.

As it is I’ve been going through my friends checking for who’s got compromised immune systems and letting them know they shouldn’t be coming to visit anytime soon. Two friends I already knew didn’t have the greatest immune systems but now there’s two more who I asked just in case and they confirmed they have poor immune systems.

I thought mine might not be great but I recently got some preventative rabies shots and the titre came back adequate, so my immune system is currently on high alert, I’m not worried about me.

 

[squidpop]

That's good, is sounds like you are being very cautious. At least it sounds like you have a really good vet. Its a good thing you are getting her tear ducts cultured. This all must be costing you a fortune.