Multiple Antibiotic Resistant Coagulase Negative Staphylococci (MARCoNS) is a form of bacterial colonization often found residing in the deep recesses of the nasal passages and sinuses. This specific type of bacteria serves as a reservoir within the body and has gained attention due to its potential role in chronic, complex health conditions. While many types of Staphylococcus bacteria are commonly found on human surfaces without causing disease, MARCoNS is notable for its resistance to multiple classes of antibiotics. In individuals with a compromised immune response, particularly those dealing with prolonged inflammatory states, this colonization can become a persistent and complicating factor.
Decoding the Acronym and Habitat
MARCoNS stands for Multiple Antibiotic Resistant Coagulase Negative Staphylococci, a name that describes the bacteria’s key characteristics. The term “Multiple Antibiotic Resistant” signifies that the organism is not effectively treated by common antibiotic medications, which is a significant factor in its persistence in the nasal cavity.
The second part of the name, “Coagulase Negative Staphylococci,” refers to a large group of Staph bacteria that do not produce the enzyme coagulase, distinguishing them from more aggressive strains like Staphylococcus aureus. These organisms are typically considered less virulent, but their antibiotic resistance allows them to colonize the deep nasal vault and sinus tissues effectively. This habitat, far back in the nasal passages, provides an ideal environment for the bacteria to evade the body’s natural defense mechanisms.
Biofilms: MARCoNS’ Protective Strategy
A primary reason MARCoNS colonization is difficult to eradicate is its ability to form a structure known as a biofilm. A biofilm is a complex, three-dimensional community of bacteria encased in a self-produced, slime-like matrix composed of extracellular polymeric substances (EPS). This protective shield allows the bacteria to adhere firmly to the mucosal lining of the nose and sinuses, making them difficult to dislodge.
The biofilm acts as a formidable physical barrier against both the host’s immune system and traditional antibiotic treatments. Within this matrix, the bacteria can exhibit a significantly increased level of antibiotic resistance, sometimes up to 1,000 times greater than the same bacteria in a free-floating state. This transforms a typically low-threat organism into a persistent challenge that maintains a steady presence in the sinus environment.
Connection to Chronic Inflammatory Response
The clinical relevance of MARCoNS is largely centered on its association with Chronic Inflammatory Response Syndrome (CIRS), a multi-system condition often triggered by exposure to biotoxins, such as those found in water-damaged buildings. In this context, MARCoNS is theorized not to be the initial cause of illness, but rather a factor that perpetuates and recycles inflammation. The initial biotoxin exposure can lead to a suppression of the immune system, including a reduction in Melanocyte-Stimulating Hormone (MSH).
MSH is a neuropeptide that plays a role in regulating inflammation, hormone balance, and protecting mucosal surfaces. Once established, MARCoNS can produce toxins, such as hemolysin, that actively cleave and inactivate MSH, further lowering its levels. This reduction in MSH creates a vicious cycle where the body loses a key regulator of the immune response, allowing chronic inflammation to persist.
The colonization also causes the release of pro-inflammatory chemicals, known as cytokines, into the bloodstream, contributing to systemic symptoms. The ongoing presence of MARCoNS is linked to the persistent fatigue, cognitive difficulties, and pain often reported by those with CIRS. The bacteria acts as a continuous source of low-grade toxicity that prevents the body from recovering fully, even after the original biotoxin exposure has been removed, making it a roadblock in the overall recovery protocol for CIRS.
Testing and Treatment Protocols
Diagnosis of MARCoNS is typically performed using a deep nasal swab, which is sent to a specialized laboratory for culture and analysis. The test confirms the presence of Coagulase Negative Staphylococci and provides a detailed antibiotic sensitivity profile. This testing is often recommended for individuals with chronic inflammatory symptoms who have a history of biotoxin exposure.
Due to the protective biofilm, standard oral antibiotics are generally ineffective, necessitating a localized, topical treatment approach. The treatment protocol is typically multi-faceted, focusing first on disrupting the biofilm and then eradicating the bacteria. A common approach involves the use of compounded nasal sprays that contain a combination of an antimicrobial agent and a biofilm-disrupting compound.
One frequently used agent is Ethylenediaminetetraacetic acid (EDTA), which helps chelate the minerals that stabilize the biofilm matrix, allowing the antimicrobial to penetrate the bacterial community. These compounded nasal sprays, such as those containing EDTA combined with antibiotics like gentamicin (known as BEG spray), are administered directly into the nasal passages. Successful long-term eradication of MARCoNS requires simultaneously addressing the underlying inflammatory condition, such as CIRS, to restore MSH levels and allow the immune system to regain proper function.