An Interview With Dr. Dennis About Treating Patients for Multiple Antibiotic-Resistant Staph in the Nose
By Catherine Fruechtenicht
An essential step in many mold and biotoxin illness protocols is the treatment of MARCoNS (Multiple Antibiotic Resistant Coagulase Negative Staphylococci). MARCoNS is said to be an antibiotic-resistant staph infection that resides deep in the noses of 80% of people suffering from Biotoxin Illness and other chronic inflammatory illnesses. Because I have shared my personal experience dealing with mold-triggered illness, chronic sinusitis, and recurrent infections on my blog, Mold Free Living, I get MANY questions about MARCoNS specifically and about how I was treated for or dealt with it. Many mold sufferers write to me because eliminating MARCoNS plagues their recovery, as it seems so difficult to eradicate. What are they to do? Is eradicating MARCoNS necessary for recovery?
My answer is sometimes shocking to people and quite controversial, because, while I was treated for fungal sinusitis and irrigated multiple times by nasal lavage to remove pus and infection, I was never tested for MARCoNS and was never specifically treated for MARCoNS. Why? Because I was already getting rid of the CAUSE of MARCoNS by getting rid of the mold in my breathing air and getting rid of the mold in my body and sinuses.
According to Dr. Dennis, board-certified Otolaryngologist and Head and Neck Surgeon who has treated thousands of mold patients, “Unless MARCoNS is causing symptoms or discolored drainage, it does not have to be treated for a patient to recover from mold toxicity—Staph is a normal part of nasal flora.” In other words, if a patient does not have an active sinus infection, arbitrarily testing for and treating MARCoNS can be wasted time and effort. As a matter of fact, the quest to eradicate MARCoNS can be a red herring or distraction from treating core symptoms or addressing ongoing mold exposures that are the true things hanging in the way of a patient’s recovery.
In order to illustrate this topic further, what follows is my interview with Dr. Dennis about MARCoNS—what it is, why it occurs, and how and when to go about treating it. The goal is to shed light on the subject as well as to offer a different perspective. I hope our interview will help those who need the information to move forward and to choose the best treatments for their unique bodies and situations.
Explaining Persistent Infection and the Link to Mold
Me: What exactly is MARCoNS?
Dr. Dennis: An antibiotic-resistant staph in the nose—could be anywhere, but people often refer to it as being exclusively the nose, especially when speaking of mold toxicity.
Me: Why is MARCoNS associated with mold illness/mold toxicity? In other words, what about being exposed to water-damaged buildings causes MARCoNS?
Dr. Dennis: MARCoNS persists in people who have had a toxic mold exposure or are living in a moldy environment because the body’s immune reaction to the molds causes a decrease in the IgG subclass antibodies in the blood, and 17% of the population have a defect in the T-cell receptor site that causes up to 9,000 times the inflammatory reaction to mold as a normal person. Once the mold—mold is a superantigen because it can dock on the deformed T-cell receptor site—docks on the T-cell receptor site, it deforms it so that many other antigens can dock on it too. This allows other antigens to also bind to it, such as bacteria, foods, and chemicals, explaining why many people with toxic mold exposure are chemically sensitive.
Mold and Decreased Immunity
Me: What is it about lowered IgG subclasses that make someone susceptible to MARCoNS?
Dr. Dennis: This dip in IgG subclasses causes lowered immunity, and then people cannot fight off the staph. Your IgG antibodies are responsible for killing foreign invaders, and you have four classes, so it could be any combo of lowered IgG subclasses that causes infection from fungi, bacteria, or viruses. That is why mold patients also get Epstein Barr, cytomegalovirus, herpes, candidiasis, chronic Lyme, and MARCoNS.
Me: So, your immune system is lowered to every pathogen because of mold exposure?
Dr. Dennis: When someone is breathing mold, they are breathing both the mycotoxins and the fungal spores. The exposure to the mycotoxins themselves causes immune deficiency. But the problem with MARCoNS is that staph is in everyone’s nose. It is part of the normal flora. MARCoNS is a fancy name for antibiotic-resistant staph. Most of these patients have had so many antibiotics that their staph is resistant to antibiotics. You don’t have to treat it if the patient has no symptoms and no endoscopic sign of staph infection (pus). But, if they were working in a hospital, you would need to treat it so they wouldn’t spread it. In regular life, though, you wouldn’t treat it unless it was causing symptoms or systemic infection. It is like trying to treat your colon for E-coli. Everyone has it. It is not a diagnosis until it becomes pathogenic. MARCoNS can be the same way, in my opinion. It has nothing to do with what is really going on. It is just another infection caused by the lowered IgG subclasses and the immune deficiency caused by the fungus.
Biofilms and MARCoNS
Me: What about the biofilms that are said to accumulate in the nasal mucosa to shield the MARCoNS from being killed or eradicated?
Dr. Dennis: Biofilms are also not a diagnosis. Biofilms are caused by the immune reaction to fungus in the nose. When fungus enters the nose in these patients, some but not all experience a magnified inflammatory response. So when the fungus enters the mucosa in more susceptible patients, it elicits the eosinophils to respond. The eosinophils are special white blood cells that come in to kill the fungus and come in in large numbers. When they encounter the fungus, they explode and release major basic protein, which dissolves the pathogens but, in doing that, also dissolves the top layer of the mucosa and causes a small pit in the lining. That pitting also destroys the nasal cilia, so nothing can move out of that pit. That then causes the staph infection that you cannot get rid of, because you cannot get the mucus out of the pit. Then all the pits crosslink and become a lathe for the biofilm to grow on. That is how biofilm forms. So, if you just treat the bacteria, you never get rid of the biofilm. Doctors then try EDTA and all these other things, but they never work long term, because they haven’t killed the fungus. But, if you treat the fungus with amphotericin or Voriconazole or one of the nasal sprays and get the mold out of the air, you can have permanent biofilm clearing. And thus, no more infection.
Me: How often do you see MARCoNS in your patients?
Dr. Dennis: I do not see what I would deem staph that requires treatment in my patients but about 20% of the time. I don’t treat it unless I see an infection with pus. I rarely treat it with oral antibiotics. I treat it locally in the nose with antibiotic and antifungal sprays or nebulization.
Me: Why would treating it orally be problematic for the patient?
Dr. Dennis: When you treat it orally, you disrupt the gut bacteria and get more Candida growth. You never resolve staph long term using oral antibiotics. As soon as you stop the antibiotics, the staph grows again. You may kill it, but that organism or another organism resistant to all your antibiotics will arrive on the scene and keep an infection going. You treat it with multiple antibiotics locally, so that it cannot get resistant. You treat it in the nose, but you’ve got to treat the fungus at the same time. That is the key. An antibiotic pair and an antifungal—you must treat with an antibiotic pair that are structurally different, then the bacteria can’t get resistant, because they can’t handle two at one time. This works MOST of the time. But I must tell you, even this won’t work long term if you are not out of the mold.
Me: Understood. Should an antifungal sinus protocol, like your Sinus Protocol get rid of MARCoNS?
Dr. Dennis: It would help, and some would get well with just that, but some would not. It depends on how bad the staph is, how bad the mucosal damage is, and how much mold they are sucking down in the air every day. You breathe in 2,904 gallons of air per day. If you do not aggressively address the air, nothing you can do will defeat that volume of mold and mycotoxins
Me: What if someone is out of the moldy environment and is in a place that they know is safe?
Dr. Dennis: The Sinus Protocol would help and would get a lot of people well, but some will need prescription antifungals like Amphotericin or Voriconazole and prescription antibiotic sprays. The protocol is designed to be non-prescription and is highly effective on a lot of people. If someone is out of the mold and starts there but is still having sinus symptoms or infection, they will need prescription help to clear.
Me: So, to be clear, the Sinus Protocol is as far as you can go over the counter, but if you are still having issues, you need to seek professional help from an ENT?
Dr. Dennis: Yes. If you are not getting better, though, chances are, you are not completely out of the exposure. CitriDrops will kill fungus. It will kill bacteria too. It is four different citrus seed oils, so patients can’t get resistant to it. Bacteria don’t know how to handle that. Like in toxicology when you potentiate a really bad toxin like cyanide, and you get a toxicology profile of how much it takes to kill a person, if you add four other toxins to that, it is exponentially more powerful. It is not linear. That is why we put four different oils in the CitriDrops. It is exponentially more powerful than one and hard for organisms to adjust to or resist.
Testing for MARCoNS
Me: Would a sinus CT scan show MARCoNS?
Dr. Dennis: No. It would show fluid or swelling or that there is a sinus infection. You wouldn’t know what it is, though until you culture it. Someone with a clear sinus CT could still have MARCoNS. MARCoNS is normal. A whole bunch of people have it. It only becomes a problem when it becomes pathogenic and is causing a symptom.
Me: What is a good way to evaluate someone for Staph in the nose that needs treatment?
Dr. Dennis: If they have discolored drainage, and it is constant, then, it would need to be worked up and treated. If they have zero nasal symptoms and their endoscopic exam shows no drainage and their sinus CT scan is normal, then it should not be treated.
Me: I hear a lot from mold sufferers who have a deep sinus ache, but no obstruction and no drainage. What about those patients? Should they seek treatment?
Dr. Dennis: That is inflammation and that is from the fungus. The fungus causes bacteria. It is all one thing. If you don’t get the fungus out of there, you are never going to kill the bacteria.
Me: Is that why the nasal lavage procedure that you did for me was so helpful—because we finally got to the fungus and cleared it?
Dr. Dennis: Yes. When you are really infected in your sinuses, you’ve got to irrigate all the pus out or you can’t ever get better.
Me: We had to do mine multiple times before I quit filling back up with an infection.
Dr. Dennis: Yes. That is direct antibiotics in the sinus and removing all the bacteria from the sinuses. You would’ve never gotten well, even with IV antibiotics. It would’ve never have happened. It is like treating a boil. You can’t take penicillin for a boil. You lance it and get the pus out. It is source removal. Sort of like remediation.
Clearing Mold-Triggered Sinus Issues Once and For All
Me: What should a person suffering from mold toxicity do to clear MARCoNS once and for all?
Dr. Dennis: MARCoNS can be virulent or non-virulent. If it is virulent, you need to treat it.
Me: So, you need to first make the distinction, and then treat it accordingly.
Dr. Dennis: Yes. The person should know if they have discolored drainage. You have two things every time—treat fungus in the body and nose AND treat it in the air. If you do not do both, you have a short-term result. You must stop breathing the mold for any mold symptoms to get better. Like I said earlier, you are breathing 2,904 gallons of air per day. That is a huge volume that no medicine on the planet can overcome.
Me: What things would prevent it from clearing?
Dr. Dennis: Getting mold exposure knowingly or unknowingly. I have found that people who cannot get sinus symptoms to clear cannot have carpet in their homes, cannot have mold in their laundry or washing machine, cannot have mold in their cars, and cannot live in homes with crawlspaces. That is not scientific, it is just what I have seen from clinical experience. In a quite simple illustration, for a seriously ill person or someone seriously sensitive, in mold plate testing, they must have air tests that show 0-2 mold colonies. For an average person, 0-4. If mold counts are still high, and they have done good remediation, they just haven’t finished yet. There is some cleaning or some further remediation needed to knock the counts down. Sometimes the candles, the fogger, and the spray can do the trick. Sometimes, it will need to be more. Every case is different. At the end of the day, all symptoms and cures begin and end with the patient’s environmental air. If they can get that right, all symptoms should respond positively. Sometimes, there are downstream issues or an additional root cause, but, for the most part, it is mold. Mold is treatable, and patients can and do get better.