Can we talk about MRSA?

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MRSA has been in the news so much lately. I know it kills a lot of people and can be very serious. On my tube-feeding support board (my daughter is tube-fed) there have been a few kids who got it and needed to be hospitalized because of abcesses near the tube site, or had to get the tube removed and allow to heal before placing a new tube. One kid seems to get it all the time and it just doesn't go away for long.

I went to my daughter's ped today and while I was there I asked him about MRSA and how often his patients have it, and what is the usual outcome. He said that in most cases the kids will test positive for it and when he calls them to let them know the results, their infections have already cleared up. It does not get bad very often. He doesn't even swab for it every time a kid comes in with a skin infection unless it looks really suspicious, and will only swab if it doesn't go away or keeps coming back. A classmate of mine (I'm a student) works in a doctor's office and said that they also get cases every day, and had four cases the day I talked to her. Again, most of the time it's not that serious.

In the local news every single day for over a week they have reported that certain schools would have so many students with MRSA, and that they had been treated and were back at school. Why is this all of a sudden making the nightly news? MRSA has been around for a long time. It seems like probably in most cases that they are reporting at the schools, the kids are clearing up and doing fine just as the ped was talking about today.

Can we talk about this? I don't have any medical experience except personally with my kids and myself. I'd love to hear from people who deal with MRSA on a regular basis.

Also, if a person has a suspicious skin infection do you automatically swab for it? Do they treat it differently in a hospital setting vs a clinical setting? If a person has it, are they told to isolate themselves (in a clinical setting) or are they isolated (in a hospital setting)?

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Specializes in Emergency & Trauma/Adult ICU.

I'm glad to see this post from someone who is not a clinician.

MRSA has been so dramatized by the media. Fact of nature: staph bacteria are almost omnipresent, and drug-resistant staph bacteria are becoming more and more prevalent, in part because we have indiscriminately thrown antibiotics at every little sniffle and cough over the last 50 years.

MRSA, along with most other microorganisms, generally does not pose a threat to individuals with healthy immune systems. Being immunocompromised and/or having areas of non-intact skin obviously raises risk. As the parent of a child who has an indwelling feeding tube, you're absolutely right to be concerned. However, the same infection control practices you already hopefully have in place - handwashing, etc. - should go a long way toward protecting you and your child.

Some hospitals in my area isolate patients known to be colonized w/MRSA, some do not. In the ER, we are seeing an increase of patients w/skin infections but not all of these are MRSA. When treating these patients I use universal precautions just as I would with any wound.

I had a patient recently ask me, "should I keep my kids home from school?" My reply: not unless you intend for them to stay there permanently. In other words, you cannot control the environment when you are out in public. Common sense measures apply - wash your hands, wash your hands, wash your hands - and be vigilant if you do notice a "bite" or other wound that doesn't seem to be healing quickly.

I see probably 3-5 skin infections per day that are probably MRSA. And many more that are not.

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Specializes in med/surg/tele/neuro/rehab/corrections.

MLOS great reply. :) I've been wondering about MRSA myself. So many pt's in my hospital have it but I've never been sick. I work as a CNA. We all wash our hands constantly and use Purell. (except the docs for some strange reason) Figure handwashing is the best way to stay healthy

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Specializes in ICU, ER, EP,.

to be honest, a majority of our patients are colonized (have been exposed to the disease and are not active). The are in the hospital caffeteria, in our malls, our grocery stores, everywhere in our community there is a risk. This is a rampant health care crisis that not every patient understands how they can cause others to be ill and don't take precautions... swimming in community pools, rubbing the lesion that bugs them then grabs the lettuce and puts it back... it's serious!

MRSA is everywhere in our community. Handwashing, sterilization and careful infection control is all we as ordinary people can do.

OP for your daughter, know that there is hand foam going through hospitals, now posted at each doorway, if not, make sure the care givers wash their hands before touching your child and insist upon it... yep, people are groaning... but I've now noticed family asking more and more about my handwashing as this is broadcast... and I've stopped using the foam, wash my hands in the bedside sink so they can see, and hand wash on the way out.... The foam makes family think you don't wash, no matter how you explain it.

ps, the nurses are not your offenders, the docs are and ask them to wipe off their stethescopes before they place it on your child... a big breeding ground for germs.

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You know, our instructor taught us that you wash your hands then apply the sanitizer...it is not one or the other like I thought.

As far as MRSA, they need something to talk about on the news besides the war going on over there. I wonder if they even realize that flu kills so many more people than MRSA ever thought about.

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Specializes in Med/Surg, Perinatal, Float.

Just yesterday the local paper had the front-page story about this. the hospital here is implementing a new policy that says all admissions to ICU are on a 24 hour isolation and swabbed and tested for MRSA. Anyone else do that?

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You know, our instructor is taught us that you wash your hands then apply the sanitizer...it is not one or the other like I thought.

That's interesting. Most infection control policies at hospitals I've been in that say we can use the alcohol scrub instead of handwashing except in cases of CDIF/other spore issues. They do recommend sink handwashing after approximately 6 uses of the scrub. A couple places I've been don't even have readily accessible sinks half the time - not sure how they got away with it.

Any infection control nurses out there with ideas?

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Our teacher tells us that the CDC defines hand hygiene as handwashing with either plain soap or antiseptic soap and water and using alcohol-based hand rubs after your hands are clean to get the invisible germs missed by soap and water. I am not sure about taking turns on which to use...maybe I misunderstand by thinking you shold only wash your hands when they are visibly dirty and can substitute the alcohol-based rubs if they look clean?

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Specializes in ICU.

If I use those alcohol based hand rubs too much it destroys the skin on my hands, so I wash my hands thoroughly most of the time, and only use it when I absolutely have to.

Luckily the hospital I'm doing placement at has sinks absolutely everywhere.

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MRSA has become endemic and we are, to employ a cliche, closing the barn door after the horse has gone.

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Specializes in critical Care/ICU-traveler.
Just yesterday the local paper had the front-page story about this. the hospital here is implementing a new policy that says all admissions to ICU are on a 24 hour isolation and swabbed and tested for MRSA. Anyone else do that?

Yes. I am currently on an assignment in an ICU in Illinois and we swab every admission, even if they are a transfer from the floor to the ICU. It became a law within the last few weeks and it is my understanding that other states are in the process of implimenting the same.

The reason is that Medicare is no longer willing to pay for the treatment of hospital acquired infections. The only way to determine if it is pre-existing is to screen in the first 24hrs. ICU's are being singled out because they are considered high risk areas. It is my opinion that in the not so distant future, we will see this for ANY hospital admission. I also think that they will start screening for other common things. Example that comes to mind is UTI's. How many times do these little old ladies come from LTC with foleys and a raging UTI? After 2-3 days when it is discovered, the hospital gets the blame and it is considered a hospital-aquired infection, when in fact they come to the hospital with the infection already brewing. I know of an ICU that has the policy of testing any LTC patient with a foley for a UTI upon admission, whether they are symptomatic or not. (Just as a CYA thing).

MLOS, you hit the nail in the head about the overtreatment of every sniffle that comes along. The media is slanting this whole "epidemic" as the fault of the healthcare workers and our "unsafe practices". In reality, the people who run to the doctor every other week and demand antibiotics when they have a runny nose, are the ones to blame.

Since when have we become the enemy?

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