This really stinks......hubby has MRSA on his hands!

[duckie]

Well imagine my reaction last night while I was at work and here comes DH and the House Supervisor to tell me he had to go home because he had MRSA and couldn't work until the facility MD evaluated the situation today and came up with a plan of action. My knees buckled and now I have several concerns, not just for him, but for myself. By now many of you knw that even after 10 years of marriage, I cannot keep away from him for long so now I'm concerned over my recent bout with pneumonia and am wondering if it was pneumonia in my lungs or could I have MRSA because we constantly kiss and if his hands were to have contaiminated his beard, isn't it possible that I could have gotten it from him??? Especially since I am still have symptoms and bring up very nasty, thick sputum. I have a follow up MD appointment tomorrow. Also, and this is really embarrassing but I'm concerned I could have MRSA in my urinary tract because my uring smells very foul, is cloudy and has a sharp pain at the end of each elimination. I'm thinking about requesting a urine and sputum culture. Do you think I'm over reacting or being paranoid???? Please give advice ASAP because my appointment is tomorrow and I need to know if I have a legitimate concern or if I'm just over reacting. HELP................also, to explain where his MRSA is......he has had blisters filled with purulent discharge forming on his hands for the past few months that appear, rupture, then dry up. We just thought he had a latex reaction but it could be a combo of that and that he was contaminated in one of the blisters by one of our MRSA patients. His washes his hands about a gazillion times a day but he is like me, a hugger and he has all the little old ladies at work in love with him, as he spoils them to pieces with hugs and affection and this is the way we figured he obtained it. Please, I need your input??????

[abrenrn]

Another thing I've experienced! Really.

Working in outpatient setting, I got a pretty bad blister on my hand. Since I had not yet figured that all my itching was due to latex sensitivity, I frequently ended up with little areas of non-intact skin - not major, just cracks and stuff.

The blister looked ugly and I went to my doctor. There was a little elevation in WBC, Believe it or not, this led the doctor to worry about endocarditis (a possiblity that had occurred to me) and despite lack of murmur,we both felt deserved hospital work up, IV antibiotics until proven otherwise (well, she didn't quite know I had agreed with her decision, I told her I'd go).

So, in I go, blood work. echo, IV something or other. Echo negative, not really febrile, finger getting worse. So, my doctor wants a culture. But, she wants a surgeon. Because this is on my hand (the amazing expanding blister) general surgeons refused, took another night to get a hand surgeon. Who, by the way, did the same thing I could have done, stuck a pin (sterile needle) in my blister, and got some pus. He said, "I'm sure this won't show anything." Overall behavior, what's behind this big deal. Which, I'm beginning to think myself, starting to call this the ten thousand dollar blister. I got a little concerned when I spiked a fever (about 103) after he stuck the needle in my finger. I thought might be related, others did not, just a fever.

Shortly after, I'm seen by ID guy. I'm feeling fine except for the finger, the fever's gone, I want to go home. Then I discover:

MRSA INFECTION!!!!

So, now it's serious again. Started IV Vanco, couple of doses in hospital, then sent home with home health for two week course or something.

I'm feeling fine, no more fevers, the job, of course, needs to know exactly when I'll be back. I know I'm fine for work (ID stuff later), but my Vanco is timed during work hours and the IV in my arm might get in my way.

I looked at my culture report, also thought, "Isn't this really just a local infection now?" At follow up, I pointed out to ID guy - thank god, one who actully listened to patients. I basically said, look, this seems local to me and it says MRSA is sensitive to Bactroban. Can't I just do wound care with Bactroban, I know how to do that. I can take Cipro to be safe.

He said, well bactroban works, if its local it will. Cipro - it says it's sensitive on report, but MRSA is resistant after a day or two.

I said let's pretend it's local then. If it isn't, I promise, I'll come right back.

He said, OK, but might as well take the Cipro.

So, IV pulled, back to work the next day, used bactroban, took the cipro, all got better.

In terms of ID: My setting was outpatient, health dept. So, MRSA is in the community. The director of the county dept (MD, MPH)saw no problem with me working in community setting given all the above.

So my, pRobably greater than $10K finger amazing expanding blister was a local MRSA infection, transmitted in a non-hospital setting to a susceptible host (non-intact skin). There were no full blown systemic symptoms until the C&S - sent it right into my bloodstream but I think my body reacted pretty quickly with fever. Though fever gone by the time I took Vanco, probably couple of days did help.

I suppose its possible that I got the MRSA in the hospital but until treated with Vanco, then Bactroban, blister kept growing.

TALES FROM THE HEALTCARE SYSTEM

[-jt]

<......he has had blisters filled with purulent discharge forming on his hands for the past few months that appear rupture then dry up.>

One of our nurses had them on the back of her neck --- right beneath her stethoscope & in the shape of it too. Dermatologist thought it was a rash. Turned out to be MRSA & took 6 months to clear.

[almostanurse]

Originally posted by ?burntout

It is the bug-MRSA-methicillin resistant Staph. aerus....

You can be exposed to this bacteria no matter what kind of antibiotics you are resistant to or not.....

NO QUESTION IS STUPID:)

thank you

:)

Some one in the hospital I am doing clinic in had mrsa, but I was scard to ask the nurses to clarify, because I dont want to look stupid. I went home and looked it up, but still didnt understand. any way thank you.:)

[duckie]

Well, I went for my pneumonia follow up today and am really getting concerned now. Doc did chest xrays, stated my lungs were still very conjested. He also ordered a urine C & S. I'm a little un-nerved right now. He started me on the same antibiotic hubby is on, just in case. I still have lots of wheezing and very wet cough after two rounds of two different antibiotics. Guess I'll just have to sit back and wait to see what happens, frettin' won't get me anywhere. Would appreciate prayers. Hugs to all! Duckie

[-jt]

Its a staph infection with a suit of armor. The resilient little bug has become resistant to most antibiotics. There are very few left that can fight it. Vancomycin can & it is on restricted use in my hospital to try to prevent causing the bug to become resistance to it too. At my hospital, its use can only be approved by the ID MDs

[abrenrn]

And, praise the lord, there is also a pill, Zyvox, as one mentioned before. I believe it's about $50/ per dose BID and some insurances are reluctant to pay. Can usually be convinced when MD willing to call, point out cost of hospitalization or home health, IV tubing, etc.

If UTI is MRSA, will need sytemic. When I had the amazing exanding $10K blister, topical Bactoban and "good wound care" ended up doing the trick just fine.

I might have just been lucky.

[abrenrn]

BTW, jt, that's the best metaphor I've heard for MRSA. OK if I use too?

[ktwlpn, LPN]

I think I would insist on a sputum c and s---with so many rounds of antibx you are setting yourself up for an active MRSA infection.Have any of you gotten workmen's comp after being out of work due to these infections?I just recently went through a problem myself-4 trips to my PCP with a UTI-on my fifth visit he was out of town and I saw his new partner.I found out that day that he had never sent a c & s...I was getting concerned about why this recurrent UTI when I have had 2 in my entire life-over 10 yrs apart? I was really worried that something else was going on....I was sick for over 2 months-will never know if I had the MRSA from day one or if the 4 rounds of antibx opened me up to the MRSA...My ltc would not let me work for 3 days...I refused to follow up with the nasal swabs after treatment-I knew I would most likely be colonized (I probably blew my nose and then took a leak and introduced the MRSA into my urinary tract) and knew that would open up a whole can of worms at work...I did some research myself-I have read that over 70% of healthcare workers may be colonized..I am sure my family is but they were not tested...I try not to think about what can happen to any of us if we get a simple infection in the future...and try to keep our immune systems "buffed" In LTC we don't isolate MRSA folk and I'm on a dementia unit-body fluids abound...and you are never sure that the staff is following proper procedure and washing their hands well.....I am trying very hard not to let my hands get chapped this winter-I always get hangnails and ugly open areas and thats another route for the MRSA to take...(needless to say I found a new PCP-one whom will pay a little more attention to me-I never should have had to go through all of those weeks of feeling like crap-and I lost my trust in him,too-I did just assume that he was sending a c &s at each visit and that the antibx was appropriate but that maybe I needed a longer course-or that I had bladder ca or something) Good Luck Duckie.....I'll keep my fingers crossed for you

[MelH]

could someone explain to me exactly what MRSA is? I have had a couple of pts with this and still don't know what it is. What is the difference btw this and VRE? THanks! DUckie, good luck to you. Hope all checks out well!

[rncountry]

MRSA-Methicillian Resistant Staph Aureus. Generally treated with IV Vanco. This is the normal staph that lives on and in us but has become resistant to nearly everything. Cultured from the nares.

VRE-Vancomycin Resistant Entercoccus. Found in the GI tract, is resistant to Vanco. Started in Europe and traced to the overuse of a specific type of antibiotic used there in animal feed. Not an antibiotic used in this country.

New one-first found right here in Michigan. A form of MRSA that has also picked up the resistance of VRE from a wound that ended up with both forms in it. Currently there is a scramble to figure out what to treat it with. Trying to remember what it is called, but can't.

Also new is resistant forms of pseudomonas, and since that is the microbe that thrives most often in vent related pneumonia's it is seen as the new big problem.

There is definately MRSA in the community now, for some stupid reason the epidemiologists are trying to figure out if it cropped up in the community on it's own or was spread from the hospital. I suppose there is a good reason for this, but I'm not sure that it matters much. Point is that it is there a there have been deaths of children associated with MRSA pneumonia when they had none of the known risk factors.

Duckie, can you not have a sputum culture done? IMHO, it is a poor practice anymore to prescribe antibiotics when sensitivity is not done, we are creating these resistant forms of bacteria by shooting in the dark and by not making sure that what is being treated is a bacteria and not a virus. The ID doc I work with is trying hard to pound this into people's heads. Like jt, our hospital carefully monitors use of vanco so that it is appropriate to the problem, as well as monitoring the use of other antibiotics, so they are not overused. If the pharmacist or myself feel that ABT is being used without s/sx of true infection we notify him and he tackles it with the other doc. So regardless of whether what is causing your lung problems I would wish for you that you know specifically what it is and what it is sensitive to. Please be forward with your doc and ask him to do a culture and if he doesn't want to ask why not. I don't want to be an alarmist, it's just that I work with the resistant problems alot, and have seen things go poorly when the doc is not cautious, MRSA or not. Please continue to let us know.

[almostanurse]

Thanks all for clearing that up:)

thanks for putting it in a way that I could understand it.

great teachers hear at allnurses:)

[duckie]

A culture was done on my hubby's hands and he was started on an antibiotic that was recommended. My MD put me on the same antibiotic as a precaution based on the fact that my lungs still wet and moist and I'm having UTI symptoms. I feel very confident in the treatment, especially since hubby has only taken 3 doses of the antibiotic and we can already see a drastic change. It stands to reason that we would have the same strain since we are intimate. Actually, I think we can even pinpoint the resident that it came from, because I haven't felt good since he was confirmed with MRSA. Truth be know, I was probably the carrier to my husband because it was on my skin and I touched his hands when they were blistered from the gloves. We are both very affectionate to our residents and that won't change, we'll just have to deal with this. I will admit I was pretty shook up at first but am calmer now. Hubbies hands look really bad but the doc says he can go back to work if he puts the topical on and wears gloves all shift as his hands are the only affected areas......THANK GOD!!!! I started my antibiotic today and will keep you all posted, but would sure appreciate prayers cause I'm not very patient and I want this gone YESTERDAY! I've heard of wearing "rubbers" during sex, but this is carrying things a bit to far!!! Might as well laugh, better than crying! Hugs to all.....maybe I should hold off with the hugs till these nasty little germies are gone! LOL