Increase in I&D's in the South?

[LeahJet]

I was just wondering if other places through out the South were experiencing a marked increase in wounds w/ staff that require I&D..... what the old folks called "risens".

I have recently moved back down South after being away several years and I have never in my life seen so many of these type infections. In our ER, we are doing up to 10 a day. I moved back the Thursday before Katrina hit (I've always had great timing).......

I've heard that it could actually be due to Katrina.....

[danfif]

I think what we are seeing is an increase in different bacterial strains that are becoming more aggressive in our society, whether it is in the poor section or in the areas of more money. I work in an inner city ER, and I would venture to guess that in a 24 hr period that we have 15 to 20 patients present with so-called "spider bites".

Yes, the large majority are of lower income levels, and not the cleanest people in the world. And yes some are drug users, but, having talked with a Doc at one of the suburban ER's he tells me that they have seen a huge up swing in the amount of abcesses over the past year, and these folks sure are not poor, and unclean. So to catagorize a lower socioeconomic level as being the cause is inaccurate in my opinion. I think that there is more to it than that. Just what it is though I am not sure.

[Gompers, BSN, RN]

I think what we are seeing is an increase in different bacterial strains that are becoming more aggressive in our society, whether it is in the poor section or in the areas of more money. I work in an inner city ER, and I would venture to guess that in a 24 hr period that we have 15 to 20 patients present with so-called "spider bites".

Yes, the large majority are of lower income levels, and not the cleanest people in the world. And yes some are drug users, but, having talked with a Doc at one of the suburban ER's he tells me that they have seen a huge up swing in the amount of abcesses over the past year, and these folks sure are not poor, and unclean. So to catagorize a lower socioeconomic level as being the cause is inaccurate in my opinion. I think that there is more to it than that. Just what it is though I am not sure.

You know, I'm so glad this thread was started. My friend has been so down, wondering "Why me? Why all of a sudden?" because he's never had this problem before, ever. I'll let him know that he's not alone, that many other people are experiencing the same thing he is. If it continues, I think I'll tell him to go to his normal doc and ask to be swabbed for MRSA. Do you think, if he is indeed positive, that a course of nasal Bactroban might cure him of these abcesses? Also, I think he is borderline diabetic and from what I understand, these wounds are more common in diabetics. See, they did a blood sugar on him when he was in the ER, and he hadn't eaten in over 12 hours at that point - it was 145. He's also been overweight, often obese, for his whole life, and he's 28 years old. I think he really needs a visit to his regular doc for a full work-up, no?

[all4schwa]

There are definetly increased skin infections among meth users, but I'm not sure why, if someone could clear that up for me, that would be great.

Obese people seem to have more skin infections d/t the decreased vascularity of adipose tissue which prevents the body from clearing bacterial invasions.

I am obese and was having what I call 'boils' on my butt. Upon research I found that it is common for people (not just obese) to carry resident staph in that region. I completely agree with the idea that people overkill on anti-bacterial; however, to prevent reoccurences (easier than the treatment), I keep a bar of Dial in the shower just for the crack of my rear. No more problems there.

[danfif]

Gompers,

Reassure your friend that he is not alone in this area. People from all ecomomic levels are coming up with this type of condition, not just the poor, unclean, and drug abusers.

You are also correct in the fact that Diabetic and over weight patients have a greater tendency to have these types of problems, due to circulation problems. And these patients are at greater risk for other complications as you might suspect. But, it is not just these types that are being seen. I have seen a good number of otherwise healthy 30 something ladies and gentelmen come into my ER with abcesses the size of Texas on all different areas of their bodies, from their face to their foot. You name the anatomical location, and I bet that I have seen it there.

It would be my suggestion for your friend to contact his own doctor, and attempt to get a referal to an infectious disease Doc and have it checked out further to see what strain of bacteria is causing his problems, and to see if the antibiotic that he is taking is the correct one for the cause of his problems.

Just as a point of refference, the majority of our patients are treated with oral antibiotics, namely Bactrim DS. Some will recieve Clyndamycin IV, but that is the exception, and not the rule. Most of the time we just treat'em and street'em. Have them come back in 2 days for a wound check, repack them if needed, then see them in 2 more days. I am not saying that this is the best way to do it, but it is the way it is done here, and from what I have seen, the results have been fairly good.

Hope your friend gets better!

Dan

[paphgrl]

What is I & D?

sorry

[hollykate]

Incision and Drainage.

[shmily5]

This is definitely not a "dirty" person's problem. I am an RN and my 2 year old daughter ended up with MRSA from what appeared to be a bug bite. This has become an increasingly growing problem within the community.

[Pedi-ER-RN, RN]

In Alabama, we are seeing tons of abcess's on our Peds pts. Doesn't matter what socioeconomic class they are in. 99.9% of them are MRSA. Some little kiddo's have them sooo bad, they have to be admitted for IV clindamycin and sometimes surgery. Have seen alot of labial abcess's that track (very bad!!).

Most parents do present and say the child has some kind of bug bite. We are also doing bactroban or mupirocin (sp?) to the nostrils for repeat offenders.

We have seen some true bug/spider bites that are also MRSA positive

[elizabells, BSN, RN]

Aw, crap. I hope that is, in fact, a spider bite on my leg. I'm going to be really cheesed if I have MRSA.

[NurseLatteDNP, MSN, DNP, RN]

You know I really have to thank you guys with all my heart! I have got my first armpit abscess two years ago. I went to the doctor and he said it could be because of my deodorant. But since then I have got more of those paifull boils that get very big before they start draining. I got them on different parts of my body now, and I was honestly ashamed to go to the doctor again. I did not want anybody to see them. I did not even want to see them. I am a very clean person, but I am overweight (lost 16 lbs in last 2 months). I have read the post with the Dial soap, and I figured, why not try it. I got to tell you, after using the soap for only one day (2 showers), ALL of my boils have disappeared. Every one of them! I am the happiest person right now! Thank you guys for all the wonderfull ideas. You are the best!

[gr8rnpjt, RN]

You know I really have to thank you guys with all my heart! I have got my first armpit abscess two years ago. I went to the doctor and he said it could be because of my deodorant. But since then I have got more of those paifull boils that get very big before they start draining. I got them on different parts of my body now, and I was honestly ashamed to go to the doctor again. I did not want anybody to see them. I did not even want to see them. I am a very clean person, but I am overweight (lost 16 lbs in last 2 months). I have read the post with the Dial soap, and I figured, why not try it. I got to tell you, after using the soap for only one day (2 showers), ALL of my boils have disappeared. Every one of them! I am the happiest person right now! Thank you guys for all the wonderfull ideas. You are the best!

A couple of local high schools in our area have had outbreaks of MRSA skin infections among the sports teams. It became a big problem last year and they stepped up the locker room cleaning and disinfecting, and it has helped.

My SIL's little brother (16 yr old) had MRSA pneumonia over the holidays and was very ill with a large opacity in his entire right lung. Our local prison had an outbreak 2 years ago of MRSA pneumonia and a couple of female inmates died due to the health care team not taking their complaints seriously.

[elizabells, BSN, RN]

Slightly OT, but my beloved Gpa got MRSA in his EYEBALL after a cataract op. Ewwwwwwww.