MRSA Diarrhea Identification & Diagnosis

Criteria for MRSA-related diarrhea - all of the following

(1) presence of diarrhea

(2) heavy growth of MRSA on stool culture

(3) exclusion of other causes

MRSA colonization requires therapy with a broad-spectrum antibiotic, often fluroquinolones.

Definition of diarrhea - one of the following:

(1) 3 or more loose or liquid stools for >= 2 days

(2) > 250 mL of liquid stool for >= 2 days

Exclusions:

(1) negative assay for Clostridium difficile toxins A and B

(2) absent or scant aerobic Gram-negative bacteria on stool culture

(3) absence enteric pathogens, including viruses

(4) negative assay for ova and parasites

(5) exclusion of medications as the cause

The diagnosis can be confirmed:

(1) by demonstrating enterotoxin in the stool.

(2) by disappearance of the diarrhea after appropriate antibiotic therapy for MRSA