Rooming MRSA infected or colonized patients with uninfected patients.

[Mammy1111]

I have a question for IC nurses or general care nurses. How many of your hospitals room MRSA infected or colonized patients with MRSA negative patients. CDC recommends isolation or cohorting for both, but if not possible room with someone who is at low risk for MRSA. I sure would like to know who in a hospital setting is at low risk for MRSA.

I am still fighting the battle in Maine for High Risk Screening for all our hospitals. It is an ongoing battle. Who would have ever thought that screening for a deadly infection like MRSA would be such a battle and the ones who fight it most are infectious disease docs!

I know of several patients just in my vicinity that have been roomed with actively infected MRSA patients. One got HA MRSA. So far the others have not. Just lucky I guess.

I have always suspected that my father, who died of HA MRSA was exposed to an infected roommate with respiratory MRSA. He had 3 roommates, who all died of respiratory illness. And he contracted MRSA pneumonia after a 12 day stay in that hospital. HE had no invasive procedures...and that is why I believe he had an infected roommate. I know...hands usually spread MRSA, but so does air and the environment when it is droplet like with MRSA pneumonia.

Thanks in advance for your responses.

[ICU_JOSIE, MSN, RN]

I work as Infection Preventionist in a LTAC (Long Term Acute Care) facility, and it sometimes cannot be avoided that clean patients are often cohorted with "dirty" patients (those w/ MDRO- Multi Drug Resistant Organism/s). As the IP, I make it a point to update the cohort list daily so the supervisors can see which patients need to be moved and appropriately cohorted. I feel better even if a clean is mixed with a dirty patient if they would consider the least possible mode of transmission. In this case, the room should be considered and both patients treated as CONTACT ISOLATION (hand hygiene before entering the room .... PPE (Gown/Gloves and Mask i.e. if a mask is deemed necessary) .... hand hygiene before leaving the room. Would you believe 80%-90% of our patient population (81 beds) are on contact isolation so I have to constanly educate and remind the staff about the importance of hand hygiene and PPE.

[Mammy1111]

Thank you for your response. My next question is, how many new MRSA transmissions have you had because of rooming "dirty" and "clean" patients together. I am not being critical. I know that the standards for LTCs are not as stringent as for acute care facilities. I am however concerned about this practice and how often a "clean" patient becomes "dirty" after being exposed in such a closed and intimate environment as having a roommate with MRSA.