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.
Hi, due to mold illness from an apartment complex, I had to move into someone else’s house. They generously set me up in a spare room, but that room has a 30-year old mattress and carpet. As soon as I sat on the bed, my sinuses popped constantly and felt like they were seizing. I followed my doctor’s orders of Xlear (xylitol spray) mixed with quicksilver’s Biocidin liposomal formula. This cleared out things…. And my sinuses stopped popping and seizing. BUT, just like you say in the article, it was temporary because the 30-year old mattress is harboring mold, and the carpet is holding mold dust from the mattress. I vacuum the carpets regularly with a vacuum that does not re-release any dust, and wash sheets and pillowcase with the citrus seed laundry rinse.
It’s all in the mattress. So I constantly get MARCON issues. Lately I’ve had profound tooth pain on the upper teeth, the dentist said it was simply pain from the roots caused by SINUS issues! Not cavities. When I went back on the sinus protocol, my tooth pain went away.
But again, just like you said…. It’s all temporary! Now I have the tooth issues again. I don’t notice discolored discharge, but I feel heavy thick substance in my sinuses in the mornings upon waking, along with brainfog, etc., etc.
I know there is no solution here other than removing the mattress and carpeting, but I am not in a position of ownership to do so, and the homeowners do not want to replace it, and I cannot afford to replace it.
But in the meantime, if I get a cot and a pad to sleep on that cot, but still slept in that same room with the moldy mattress and the carpeting nearby, will I be able to get better? Or will the mattress and carpet continue to ruin my efforts? I could move to sleep in the hallway, where there is no mattress, although there is carpeting there too.
Would also like to add, that I feel a lot of stuff in my sinuses, and it slowly moves from one side to another if I switch from laying on my right side or my left side (takes about 10 minutes or so)… but even with the xlear spray, I don’t see much of anything come out. Not sure if that means the substance is very deep in the sinuses, or maybe I am misidentifying the ‘movement’ as fluid when it might actually just be pressure/inflammation that shifts to the side closest to the mattress?
I am inserting a link to the Environmental Treatment Protocol that I developed for patients who are unable to move or to remediate right away: https://www.sinusitiswellness.com/environmental-treatment-protocol/ I would advise spending your efforts on implementing it as much as possible in the room where you are sleeping to mitigate exposure as much as you can. The environment is the cause, so the environment MUST be dealt with as much as is feasible at this time. Ideally, you should get to a safer space at some point. You can also do things like enclosing the mattress in an encasement to also create some sort of barrier. Employing nasal rinsing might also help with symptoms as would using something like Sinus Defense to create fungal resilience to exposure. All of these things are just Band-Aids, though, until you are in a position to better control the environment. In the meantime, just do the best you can with these tools and you will likely experience a marked improvement in symptoms.
What about the issue of mycotoxins being constantly reabsorbed after it’s removed from the bile? Is it really possible to detox and heal from mold without using a binder to strip the mycotoxins from the bile before they are reabsorbed again?
Binders are fine to use. I just do not like using them with any patients having trouble with constipation or who have lots of pituitary issues as Rx binders can deplete the body of crucial hormones and cholesterol needed for recovery. I do use GI Detox and Zeobind sometimes. In the case of the sinuses, nasal rinsing with a natural antifungal and sinus health are key, because you are removing the mold and mycotoxins at the entry point to the body. Therefore, you are not allowing them to cross the blood-brain barrier to be absorbed. I also like the therapeutic use of O2 for mold patients, because the cells slam shut protectively and do not allow the body to detox. The O2 creates that opening and safety signal for release.
I’ve had 4 sinus surgeries within 7 years starting with a sinus infection that never went away after repeat antibiotics/steroids. First surgery fixed a deviated septum and removed polyps and just showed inflammation, but I felt worse afterwards with a raging infection. Next three surgeries I was told path showed “mucin” and “eosinophils” but no fungus showed up in culture, but the surgeon said that was not unusual and said he saw it during surgery. So after many rounds of antibiotics, nasal rinses, steroids, even allergy shots, etc., nothing has really worked. I never feel well or feel like my old self. I’m always tired. I’ve been on prednisone now for 3 years with doses between 20 mg to my present 5 mg. It’s the only thing the helps me feel like I can deal with it. I am also on compounding nasal drops of itraconazole and also steroid nasal drops. I use decongestants now and then especially with barometric changes. I also recently started on Dupixent in the hopes of relieving some of the pressure, in case of polyps, but it seems I always have sinus pressure. My ENT stated that mold is everywhere in the air outside and inside, and a hyperreaction to mold in my sinuses is difficult to treat. My home is spotless. I keep it dust free, have air purifiers in the house and I watch the humidity level carefully and use a dehumidifier if it goes above 45% in my home. I also have osteoporosis from the steroid use. It’s difficult to imagine that I’ll live the rest of my years feeling this way. It’s an invisible disease and nobody really can understand how sick it makes you feel. My doctor said your house can be mold free, but once you step outside it’s everywhere and of course then my sinuses hyperreact and I’m miserable. Im not sure the mold plates, which I’ve thought about, would actually help. Any suggestions would be appreciated.
From Dr. Dennis:
Here is an article I just wrote. I do not agree with the long-term use of steroids for symptom management only. It is not helping you with what is causing the problem. That may be one of the issues for you. Steroids can make the whole body, especially the nasal mucosa more susceptible to fungal infection. Over time, they can also impair healing. Just something to think about. Surgical irrigation of all sinuses with an antifungal may be a solution to consider. In-office lavage done by an ENT with an Rx or natural antifungal and then home use of some of the products in the body protocol I developed may also be helpful. Mold is everywhere; that is true. But, indoors hidden mold growth from water damage in walls or a crawlspace is different–the exposure level is much much higher. I would recommend testing your home for mold and would also recommend both IgG and IgE antibody testing for mold. This would indicate both allergic inflammations as well as chronic inflammation from an indoor exposure-type scenario. Here is the article: https://www.sinusitiswellness.com/finding-a-mold-literate-doctor-or-an-ent-specialist-who-treats-the-fungal-cause-of-chronic-sinusitis/ Here is another one too that may help: https://www.sinusitiswellness.com/understanding-the-physiology-of-a-mold-reaction/
Please help me Dr I’m really bad something is so wrong and have nonstop yeast and mold and metalic taste and mucus lining dried out eyes and nose sticky metal taste won’t stop or yeast nonstop symtoms won’t stop and getting worse and skin and itching and I don’t feel real eyes burn toxic in tissue and lymph fingers numb and left foot zapping on Skype n can’t handle cold or smells or carry on conversation..eyes burn keep saying momma outloud and not on purpose rears itch inside bad ..I have black eye floater in eye that’s been there for two week on vision won’t go away it moves when I move eyeball ..help me please think I have marcons and have mycotoxins and mast cell and hoshimotoes..I got worse in fall..love candy
Here is an article with links to many websites to find a qualified doctor to help you in your area:
Another great article! As a scientist AND someone healing from mold toxicity, I am intrigued by some of the statements in the article.
Would it be possible to provide references from peer-reviewed journals on:
1. the fact that the body’s immune reaction to mold causes a decrease in IgG subclass antibodies in the blood?
2. 17% of the population have a defect in T cell receptors sites that causes up to 9000-fold increase in the inflammatory reaction to mold
I will post more as Dr. Dennis gets references to me. In the meantime, here is an article on IgG subclass deficiency, which is why things like asthma and recurrent infections become problematic from living in mold.
Here is a helpful article on CIRS and the chronic inflammatory response to mold from a water-damaged building.
Shoemaker RC, Mark L, McMahon S, Thrasher J, Grimes C. Research
committee report on diagnosis and treatment of chronic inflammatory
response syndrome caused by exposure to the interior environment of
water-damaged buildings. Policyholders of America. 2010 July 27:1-161.
More to come . . .
Here are links to articles that Dr. Dennis sent to me: