ORSA Decolonization

[Megan-Cho]

Hi Gang,

My son has been cultured positive for ORSA from a leg wound from a horse riding accident in August. It was nearly healed, stitches had been out a couple weeks but then it started with just a little breakdown.

We took him to the doctor and he said nonstick bandage and triple antibiotic. We came back a few days later and the wound had grown to the size and exact shape of the bandage. He cultured the wound and put him on Keflex. Three days later, my son had broken out in a rash all over but no fever. The back of his leg had started weeping from sores the shape of the wrap to hold the bandage in place. He changed the drug to Cleocin, fearing allergic reaction and re-cultured.

The rash grew all over my sons body in a short time and he had no relief with benadryl. The doctor referred him to an ID doc at Children's Hospital. The ID docs conferred with the Dramatologist, I mean Dermatologist (witchy type). They determined my son had a reaction to neomycin, causing the breakdown and resulting infection. He's on bactroban and lidex now and clearing up rapidly. They used Mepilex bandage to hold the medication. If you haven't seen this stuff, get ahold of some. It is AWESOME. If the wound isn't draining, it can be used for 3 days, just re-applying the medication. It's self-adhering so no tape is needed. It was just what he needed to keep from tearing up the rash and new sores.

Anyway.... to my questions... First can you keep us in prayer and second, now that he's colonized with ORSA and has to live with a tube of bactroban around his neck the rest of his life... What do I do? How do I balance paranoia with reasonable care? He shares a bathroom with his 14 year old brother. What precautions do I need to take there?

Have you ever heard of de-colonization? Do you know of any research on it? I've heard of low strength bleach baths, do these help or hurt by removing normal flora? What other inanimate objects must be cleaned or replaced? I'm willing to do what it takes, just need to know what it takes. My son is a very active outside kinda kid. He will always have an open wound on his body. I can't closet him in and make him feel like he has coodies.

I'm hoping some of you can offer some real life suggestions born from experience.

Thanks

[akcarmean, LPN]

Sorry that I don't have any sugguestions BUT I will keep your son and family in my prayers. Keep us posted.

Angelia

[lossforimagination]

I've never heard this term. I did a search and found nada. What is this?? Anything kin to MRSA?

Hi Gang,

My son has been cultured positive for ORSA from a leg wound from a horse riding accident in August. It was nearly healed, stitches had been out a couple weeks but then it started with just a little breakdown.

We took him to the doctor and he said nonstick bandage and triple antibiotic. We came back a few days later and the wound had grown to the size and exact shape of the bandage. He cultured the wound and put him on Keflex. Three days later, my son had broken out in a rash all over but no fever. The back of his leg had started weeping from sores the shape of the wrap to hold the bandage in place. He changed the drug to Cleocin, fearing allergic reaction and re-cultured.

The rash grew all over my sons body in a short time and he had no relief with benadryl. The doctor referred him to an ID doc at Children's Hospital. The ID docs conferred with the Dramatologist, I mean Dermatologist (witchy type). They determined my son had a reaction to neomycin, causing the breakdown and resulting infection. He's on bactroban and lidex now and clearing up rapidly. They used Mepilex bandage to hold the medication. If you haven't seen this stuff, get ahold of some. It is AWESOME. If the wound isn't draining, it can be used for 3 days, just re-applying the medication. It's self-adhering so no tape is needed. It was just what he needed to keep from tearing up the rash and new sores.

Anyway.... to my questions... First can you keep us in prayer and second, now that he's colonized with ORSA and has to live with a tube of bactroban around his neck the rest of his life... What do I do? How do I balance paranoia with reasonable care? He shares a bathroom with his 14 year old brother. What precautions do I need to take there?

Have you ever heard of de-colonization? Do you know of any research on it? I've heard of low strength bleach baths, do these help or hurt by removing normal flora? What other inanimate objects must be cleaned or replaced? I'm willing to do what it takes, just need to know what it takes. My son is a very active outside kinda kid. He will always have an open wound on his body. I can't closet him in and make him feel like he has coodies.

I'm hoping some of you can offer some real life suggestions born from experience.

Thanks

[Megan-Cho]

I've never heard this term. I did a search and found nada. What is this?? Anything kin to MRSA?

Oxacillin Resistant Staphylococcus Aureus. This is the same thing as MRSA (Methicillin Resistant Staph.Aureus). The lab test for antimicrobial efficacy in the past used Methicillin, now uses Oxacillin. Why is Oxacillin tested instead of Methicillin? Oxacillin is more resistant to degradation in storage and is more likely to detect most heteroresistant strains. In addition, Methicillin is no longer commercially available in the United States. Antimicrobials like Oxacillin and Nafcillin now are used for treatment of S. aureus infections.

It's often misdiagnosed as spider bites. It's spreading like wild fire through

school athletes, day cares and jails. This is one of 3 or more strains not found in healthcare settings. It's very aggressive. It attacks healthy skin. I have to nearly paint his body with bactroban and about 200 Qtips three times a day. I'm collecting information on CA-ORSA and posting it on a site.

I would like to see the CDC's elite guard the EIS, take a more proactive or public approach to tracking strains and getting the word out. To that end, I email people I find on the net that might have influence and I copy the EIS and CDC on each one!

Since I can't directly battle the bacteria, I can battle people not

knowing about the newer strains. Here's my site. I just started it this past October and already it needs to be updated with new and more severe instances of the spread.

http://www.caercoork.com/orsa/orsa.html

The hospital nurse said my son had O.R.S.A. If I wasn't already in the healthcare industry I wouldn't have had a clue what I was in for.

[alwayslearnin]

Just a tidbit of information-

The strains of MRSA or ORSA (now part of an umbrella term MDRO's-muti-drug resistant organism) are refered to as "Community Aquired". In our region, the community aquired (ca) mrsa is more virulent than hospital aquired.(shiver) It's kind of scary. I think about how much it takes to do surviellance in a hospital for hospital aquired MRSA and wonder, who would be tracking all of the ca MRSA??? What a job! I think, once again, education is going to be a large part of the solution-good handwashing, wound/drainage containment, etc