Mrsa/vre Pts

Sounds like alot of letters.

First of all it makes no sence to me.

Do they think you could acquire a double dose of MRSA?

It sounds like the DRG system, Ha, Ha,

One diagnosis, one treatment, one insurance payment?
just kidding


But very interesting question
Hmmmmmmmmmm

Here's a guess...
You can have VRE and VRE/MRSA because more than likely whatever antibiotic they are receiving for the VRE will also work on the MRSA, so cross contamination wouldn't be much of a big deal.

However you couldn't have MRSA and MRSA/VRE because you would expose the MRSA patient to the VRE which wouldn't be affected by the antibiotic they are receiving for the MRSA.

Good guess!!!!


Makes sence!!!!

It still sounds like "The house that Jack Built"
I had to read the post again for it to sink in, I'm a little ADHD.

Sounds like science fiction ........but it is possible that the Vancomycin Resistant Enterococci can pass the genetic material for vancomycin resistance onto the MRSA microbe creating the super bug 'Vancomycin Resistant Staph Aureus" - hence the idea of keeping those with MRSA away from those with VRE....

Sorry, I don't know the answer to that question. I am having to deal for the first time to my knowledge, with MRSA. I am working in a rehab facility and have had a few outbreaks. These outbreaks have occurred in different buildings. The employees do not go from one building to the other, and neither do the residents. I am trying to figure out how this is spreading or if each case is just an isolated case. I would appreciate any information on this bug and how to eliminate it. I was thinking of discharging all of the residents who I suspect of having it. Does anyone know how long this bacteria incubates? Is it more active in certain times of the year?Any recommendations?

I wish we had an "isolation unit" where I worked. Of course it would have to be the biggest unit in the hospital. I can't remember a shift where I haven't had at least one patient with either MRSA or VRE. It seems like EVERYONE has it. And I have had several SEVERAL patients with both. SCARY STUFF. MRSA of the sputum, urine, stool, wound, blood. Most of the VRE I've seen is in urine, but tomorrow is always a new day, right? As for the poster who hinted to eliminating it...... Common sense would tell us that proper handwashing and universal precautions, etc...... But then why do we keep having all these new cases? And here is another thing I was curious if anyone else has seen. Patients who have NEVER been in the hospital, have no direct contact with anyone who has MRSA or works in healthcare, etc etc etc, AND they are presenting with MRSA of something!! Scary it is!! I have nightmares of the world being overrun by a "SUPERBUG" As for the question by the OP, I have no idea, the policies on isolation change by the minute where I work, so I'm as confused as anyone. Do you have an infection control nurse you could ask?

lol, I am the infection control nurse you could say. There are only two of us nurses at this facility which has a little more than 200 residents. They are there for Substance Abuse education and for the most part already detoxed and well. This problem has arisen. I am thinking of culturing all of the intakes from now on. I am just not sure if I should reject people who have positive nasal cultures without symptoms (carriers). I am going to run that question by our visiting physician. I need to writeup a policy and procedure concerning it. I have been there for 5 years, and only have about 5 cases a year that are easily resolved. This is becoming a problem now. Oh, I receive my residents straight from the jail, too. It is amazing I haven't had this problem before.

It's important to realise that 30-40 % of the general population are colonised by Staph Aureus which for most of the time does not cause us any problems... just part of our normal body flora.
The first resistant staph aureus (Methicillin Resistant Staph Aureus) appeared I believe in the 1950's - shortly after the introduction of the first antibiotics.

Studies done on health care workers show that we do pick up MRSA at work, BUT that we tend to become transient carriers, meaning that we tend to "lose" the MRSA bacteria shortly, with our normal body flora prevailing.

The problem is that we can and do transmit the bacteria to others who are more at risk from being colonised with an antibiotic resistant bacteria (the immunocompromised person, those with wounds, drains etc). The risk is in the potential to develop an infection....don't forget the difference in colonised and infected with MRSA!

Studies on handwashing consistantly show poor compliance (some with as little as 50% compliance) -so if health care workers are not washing their hands, it's hardly surprising that transmission is rampant. By the way, nurses are much better at washing their hands than any other class of health care workers

Regarding the control of resistant Staph Aureus in health care facilities, you need to refer to your state or provincial guidelines. (I doubt very much that you would be allowed to "refuse" to admit a person colonised by MRSA).

In most of North America MRSA is considered endemic in most acute care facilities, and yes those affected recover from their acute illness and are discharged home into the community whether or not they are carriers of MRSA. Many will decolonise by themselves after discharge from the hospital, some may not... The end result is that the incidence of MRSA in the community is on the rise.

For general information on MRSA - the CDC web site has a wealth of information.

Have you heard yet of CA-MRSA? Community Acquired MRSA. Look on the web. It seems to fit with those that have had no hospital contact