MRSA fear and bewilderment

Nurses General Nursing

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Now I have a microbiology class under my belt, and I know what bacterias are. What I am asking here is for anyone to mention a few words of their noteworthy experiences of MRSA, VMR, or C-Diff isolations gone wrong.

For example, I've encountered isolation rooms where the PT can have MRSA in their wound, or in their sputum, or C-Diff in their stool. Yes, C-Diff isolation. (I always want to see if it smells different :-)

I'm trying to understand this from a practical standpoint. How can MRSA harm me if I got it on me directly from a PT, or from cross-contamination? What would my normal body do if I somehow, someway, got C-Diff or MRSA in it? Would it be like getting a fever?

When we gown up, I know we are preventing noscomial, and we discard the isolation masks, gown and gloves after each PT contact. Those gown are sometimes hot to work in, and I start to sweat, especially when you have to wear a mask and work as a cna.

I'd love to hear from anyone who has a story, from their own experience, when MRSA or C-Diff spread from an isolated PT, and who was effected. Wouldn't a normal immune.sys take care of this? I am slightly mistified by MRSA, and how if can effect PT's or nurses if it is spread. Thank you, Respectfully, Mario Ragucci

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I stand to be corrected, but your average bug is ok till it gets into the wrong place. Staph Aureus lives quite happily in nurses' noses, and causes no problems. In the bloodsteam is a different matter.

Your intact skin is your first line of defence to any infectious agent, if the skin is broken and a wound is infected, then the healing process is impaired. When the infecting bug is resistant to antibiotics, then it is more difficult to get rid of. Gowns, gloves, and Universal Precautions protect you, and the patient, from the bug being transmitted.

Mrsa is fairly widespread in the community, but social contact is a low-risk activity.Only in a hospital setting, where patient's health status is already compromised, does it become a hazard.

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You are not likely to become infected with MRSA if you use BSP. Some health care have had MRSA positive nasal swabs so it is beleived they must have inadvertently touched their nose after coming in contact with MRSA. In my workplace the employee is treated and returns to work after negative swabs.

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Mario, what you are really trying to prevent is spread of a highly dangerous organism that is a mutated product of the original...just because it is staph aureus doesn't say it all...it is a staph aureus with a FULL METAL JACKET. Your immune system may handle any compromise of this organism if it is functioning correctly and the numbers of attacking organisms are tolerable.

But...you carry those over to a patient who is compromised and bingo...they're done.

I remember years ago working burns, we had a Klebsiella and a Pseudomonas strain that we couldn't stomp on with anything, pts would reach renal toxicity and the bugs wern't even slowing down. Even with good hand washing technique and changing gowns when leaving work my 3 year old son got a cold and then a superinfection.....Klebsiella! Identical strain at the burn unit and I almost lost my son.

I think what is important to remember is when the bug is transferred it isn't exactly the same bug. It has already initiated and has been in various stages of mutation, developing mechanisms of resistance to the last antibiotic it encountered...the problem is the last antibiotic it encountered is our biggest hammer.

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My gastroenterologist told me, if i recall correctly, that everyone has Cdiff in their stool...it's the overgrowth and overload of the toxins that causes the prob....a coupla yrs ago i had GE and my stools kept coming back + for Cdiff...even after Flagyl and Vanco...turns out i have UC, that was the problem...

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Mario,

You ask about a topic that is close to my heart. I love Infection Control. I hope your facility educates you on it. Ask questions until you are satisfied. Sometimes the people who make these Policies and Procedure books speak in terms that aren't easy to understand.

I do the infection control monitoring for my unit. Basically there can be harm to you if you are run down not getting enough sleep, if your resistence is low. Nurses are known for working crazy hours, all different shifts, over time & double time. This is when your resistence is low.

I could type forever on this topic. When your patient has MRSA in the sputum your danger zone is the immediate 3 feet around your patient. Everything in the room is considered contaminated. If you go into the immediate 3 feet around the patient you need all of your PPE on (personal protective equipment). Once you enter the door you can't put them on they are outside of the door on the isolation cart. That is why we put them on outside of the doorway. Once you are done in the room you should take all the PPE off and wash at the sink inside of the room. Use a paper towel to turn the faucit off and if needed to close the door behind you if the sink is in a bathroom inside of the patients room. When you come out of the patient's room your hands should be clean and ready to go. On my unit I have changed the routine of keeping the isolation vital sign equipment on the isolation cart to keeping it in the bedside drawer of the patient. They is a possibility of transmission.

They are also more super bugs out there, MRSA, VRE, RESISTENT PSEUDOMONAS, MRSE & one or two others that have not hit the west coast yet.

Feel free to email with any questions that you may have. Above all you must follow the policies and procedures (P&P's) of your facility. Alot of Infection Control is precautionary. I do know that VRE lives on a hard surface for 7 - 10 days. That is a long time for an organism to live outside of the body.

Just think if it was on your badge how many places your badge would go in 7 days.

Cali

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sunnygirl272 is right. We all have Cdiff. But when a comprimised patient recieve ab it kills the normal flora that keep the Cdiff in check, then it goes wild causing the smelly foul infected stool.

Used to watch these bugs go down the hall. From the first bed to the last, spread by caregivers, I'm sure. WASH YOUR HANDS AND USE PRECAUTIONS!

MRSA is no longer isolated to hospitals, no longer nosocomial, and is now out in the community being caught by people whove not been with in 10 miles of a hospital. Oh My!

Have not seen Resistant pseudomonas or MRSE yet. Guess it's just a matter of time before they and others get here too.

It's very scary to me...b/c I've read about what it was like in pre ab days. People would die from infections that we have taken for granted as being treatable. No longer treatable, people will die.

I recently posted on this BB about how scientists are using cloning in cows to produce human antibodies, they were talking about injecting the antibodies into infected people to fight the infection. Sound good to me! Someone better come up with something to fight these infections and soon! The thread only had a couple of posts that said something negative about it all and very few views. Oh well, guess I'm more interested in this stuff than others are...but I'm not sure why.

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Thank you very much for responding to this question of mine. There is so much to learn and understand about these bacteria, and I like to imagine I can actually see them, when i know i can not. Your information here feeds my imagination, and I thank you again. I am very interested in it, but going through material on bacteria can be dry reading. This helps me gain better perspective.

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imagination is the key!!!!!!!!!

OOPS!!!!!!!!! wrong rthead...........

intnetionllay,

never

orcim

***** micro may be wrong.....often is'

---------------but there is so much out there that is gonna' get us......

all we can do is to be prudent and use universal precautions in all we do.............

other than that, right or wrong.....this is the attitude I 'withthrong'

:p :p :p

be well all, and

life is too far serious to take so seriously ..........................

micro

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Flowerchild;

How long and where in the country is MRSA in the community?

How has it been contracted? This is very scary.

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Originally posted by Glad2behere

. Even with good hand washing technique and changing gowns when leaving work my 3 year old son got a cold and then a superinfection.....Klebsiella! Identical strain at the burn unit and I almost lost my son.

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Damn!!! What a horrifying experience!!! I wish that every nurse I see driving to work in scrubs, wearing those same scrubs all day, and then going to the supermarket, buying groceries for dinner, and, presumably, going home and cooking dinner while wearing them could read about what you went t hrough, even while using good universal precautions! Thank God your son made it through unharmed.

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Motivated SN,

From the National Foundation for Infectious Diseases:

This is from a report done in 1998. I have heard of more cases since then. There was even a post on this BB somewhere about a nurse who took MRSA home to her kid. I'll try and find it for you.

"The vast majority of MRSA infections are acquired in hospitals or long-term care facilities (LTCFs). In a few cities, MRSA has been acquired in the community by intravenous drug users. Several recent reports have suggested MRSA may occasionally be transmitted in other community settings, particularly among preschool-age children, some of whom have attended daycare centers. Further studies are needed to determine if transmission of MRSA in community settings is becoming more common or is limited to a few geographic areas."

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