MRSA in the nares

livinthedreamRN · Jun 27, 2010

Good Question. I had minor surgery a few months ago and was swabbed in the nares for MRSA. I was not surprised to find it was positive. My place of employment didn't seem concerned. I certainly am not going to wear gloves. gown and mask all day at work so am I putting my co workers at risk?

burnout59 · Jun 27, 2010

Probably every nurse in a hospital or nursing home has MRSA in the nares. Big surprise, huh? Our hospital has the same policy for MRSA in the nares, full contact precautions. In addition, their visitors, who brought them to the hospital and will take them home, have to dress out. But the patient who is coming in for a bronchoscopy with possible TB can sit in the waiting room without any precautions being maintained. Go figure!

Sally Lou · Jun 28, 2010

To protect the patients who have open wounds.

My husband has been in and out of the hosp more times then i'd like to count the past 2 yrs. This last time he went in, with a barely open wound, it was infected with MRSA. They swabbed it when he went in for that surgery and there was no MRSA there. We'd been having nurses come into our house to do the dressings and deal with the picc line. I have NO doubt that one of those nurses picked it up somewhere and gave it to him. btw, It cost him his leg up to his calf.

armondieki · Jun 28, 2010

Prevention is better than cure.

Flo., BSN, RN · Jun 28, 2010

I think I am just missing the maybe the mode of infection. If it is a nonactive colonozied person can you pass an active infection to someone?

mercurialnerd · Jun 28, 2010

I agree, it's confusing--I've heard so many contradictory things. But my understanding (with my experience of the past nine months as a colonized person) is that the big risks seem to be (1) touching or picking at your skin (risk to yourself), (2) sharing personal items such as towels, (3) directly touching an opening on the skin of another person after not washing your hands (what are the chances?) Not good to hang around with immuno-compromised patients or people with invasive devices (IVs, etc.), but I think if you wash your hands that is a huge part of prevention. Wear a mask if you have a cold. Wash your hands after blowing your nose. Cover all wounds. It is a good idea to sanitize surfaces in your house/enviroment more often and to wash your hands often. Use bleach or isopropyl alcohol--NOT antibacterial stuff, which encourage antibiotic resistance. We have hand sanitizer at all sinks and by the computer in our home. Above all, seek treatment immediately (including a culture) if you suspect a staph infection.

LorderrorproneRN · Jun 28, 2010

Hi there

well i guess to answer your question, what most people consider is MRSA is an infection, which it isn't. MRSA is basically Staff.A that has mutated to be resistant to methicillin. so when you swab people for MRSA VRE swabs you aren't swabbing because there is an infection in that site, you are swabbing because you want to know if the person is colonized by that strain. so why is a person with MRSA on contact precautions... well yea why indeed... the person should and probably a good idea to be placed on Droplet precautions not just contact. if that person sneezes then that MRSA is gone "airborne" right? soo droplet precautions would make most sense. the reason we put people on contact precautions if they have MRSA or VRE is to limit its spread... most often its there as a reminder for the nurses to practice hand-washing .... lol more than the once a day wash.

XingtheBBB, BSN, RN · Jun 28, 2010

We swab to cover our butts when payors refuse to cover HAI. If a pt develops MRSA in a wound or systemically we can see if they actually came in colonized or not. If they didn't, it's our fault, we eat the cost. If they did, we might get reimbursement.

So I agree with the above poster... why do we isolate? It's crazy. I suspect it's to cover our butts again?

Spring_Peeper · Aug 27, 2011

Can anyone refer me to any scientific articles about swabbing nares for MRSA? Thanks in advance. :specs:

Altra, BSN, RN · Aug 27, 2011

We'd been having nurses come into our house to do the dressings and deal with the picc line. I have NO doubt that one of those nurses picked it up somewhere and gave it to him. btw, It cost him his leg up to his calf.

You don't think it's possible that your husband, or you, or any other person he has contact with, could have "picked it up somewhere" ... that it was "NO doubt" one of the nurses?

I'm sorry for your husband's troubles.

TheSquire, DNP, APRN, NP · Aug 31, 2011

MRSA is community-acquired now.