The mother of Sarah Murnaghan, the 10-year-old Newtown Square girl whose quest for a lung transplant made national news, said Wednesday that she is "making small steps in a positive direction."

Janet Murnaghan said earlier this week that Sarah, who is a patient at Children's Hospital of Philadelphia, had pneumonia in her right lung.

In posts on Facebook, Janet Murnaghan said her daughter is still requiring "very high" support from a breathing machine, but that she is requiring lower levels of oxygen than she did over the weekend and that X-rays show more air in her infected lung.

"Overall, we are cautiously optimistic," she said.

While the infection initially was believed to be caused by aspiration of stomach contents, Janet Murnaghan said Tuesday that the lung is infected with pseudomonas, a bacteria often spread in hospitals. "We are playing with antibiotics to provide greater coverage," she said. "This will be a slow recovery but we are on the path."

According to the U.S. Centers for Disease Control, pseudomonas is present in the everyday environment, but infections are most common in people who have been hospitalized or have weakened immune systems. People who need breathing machines or have skin wounds are "potentially at risk for serious, life-threatening infections," the CDC said. Some strains have developed resistance to antibiotics.

After Sarah waited 18 months on the transplant list for a set of children's lungs, her parents, along with several local politicians, campaigned for a change in organ allocation rules that would give her easier access to lungs from adult donors. They argued that adults were getting donated lungs faster than children who were sicker. Adult lungs need to be cut down to to fit in a child's chest.

The family won a court order in Philadelphia and temporary changes in the rules.

Sarah received a set of adult lungs on June 12, but they failed to work properly. She was transplanted with another set of adult lungs on June 15. Those lungs were known to have pneumonia, but Janet Murnaghan said earlier this week that the infection was removed before the transplant and that Sarah did not test positive for that infection after surgery.

According to the United Network for Organ Sharing, five children have now been granted their requests to be listed as adolescents - children over 12 have access to adult lungs - since Sarah's family filed its lawsuit. Those five would include Sarah and Javier Acosta, another young patient at Children's Hospital, but Anne Paschke, a spokeswoman for the network, said she could not talk about specific patients.

Two of the five patients have now had transplants, she said, including one that was the result of the original listing as a child. Children get first shot at lungs from other children.

Through a spokesman, Steve Harvey, the lawyer for both children who were listed for transplant here, said Javier has not yet received a transplant.

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