ER Nurses contracting MRSA

[ernurseodessa]

There has been a large number of patients coming through the ER, with MRSA, both CA-MRSA and HA-MRSA. Now some nurses are coming up with abscess. Is there a wide spread known epidemic of nurses contracting MRSA from the large pt flow in the ER? I know we hear over and over again how wearing gloves and constant washing of hands prevents cross contamination. Is this enough? Any other nurses seeing this?

[LIZPICURN]

That is a very good point. My doctor never addressed if I was living with family etc. Thank goodnesss, this was not the case. I was living by myself at the time.:uhoh21:

[gr8rnpjt, RN]

My daughter was visiting family in Pittsburgh. She lives in San Diego at Miramar. Her husband (who is currently in Iraq) was getting ready for deployment and they decided to baptize their baby a couple days after christmas due to his deployment. The day after Christmas my son developed scarlet fever. The day after that was the christening. I was afraid to hold my grandaughter on her christening day due to my son having scarlet fever. The day after the christening, my son in law's brother who was the godfather, was hospitalized with a lung infection. Turned out to be MRSA pneumonia. A couple weeks after they went back to San Diego my daughter called and told me about this rash on her legs. Turned out to be folliculitis and cultures were + for MRSA. My question is, how does MRSA pneumonia spread to my daughters legs. And I was so concerned about the scarlet fever, while the godfather was breathing all over my grandaughter with his MRSA germs!

this is all very scary and I was wondering if it is possible that the dog spread the mrsa germs over at that house where they were staying?

[ernurseodessa]

I can't help but to wonder why more isn't being done to prevent this insane infection from getting further out of hand. Has anyone seen any teaching material out there that we can give to our patients? Not to mention our families for prevention and/or manangement of MRSA.

I know that in the small town ER that I work in, we see at least 5 "spider bites"( or at least thats what the pts call them) a day. I know that a lot of our Docs don't even culture them, they just treat it as though it is CA-MRSA. I also can't help but to wonder what types of problems will arise from this way of treating it. If it's not documented by testing, as MRSA then I have a hard time tracking how many come through the ER. I would love to do a study on this.... maybe all ERs should. I wonder if all staff members used the treatment of nasal bactroban for one week, and then one time a week for a month, it would be helpful in cutting down our risk of spreading and contracting MRSA.

[Nurse1966]

Your Infection Control nurse should haver information for discharge teaching for patients with MRSA and other resistant bugs. If not, if your hospital has "Carenotes" that might help, or the CDC website has great information. I don't know if dogs can carry MRSA, but we recently had salmonella that was transmitted via a dog to a little girl, so I guess anything's possible!

[rjflyn, ASN, RN]

For what it's worth a hospital I worked at in NC several years ago was doing a study, every pt from a nursing home or another hospital had nasal, axillary and groin swabs collected. At that time one out of four were colonized with MRSA.

I would excpect that number to be higher now.

Also based on conversations with various coworkers and other providers alot of use health care workers are colonized as well. One has to remember though colonization is one thing infection is another. Remember each square centimeter on you has 10,000 bacteria present. Its our generally health imune systems that keeps us from getting ill. Healthy people generally dont get sick one day and die 2 or 3 days later.

Rj

[carachel2]

Your Infection Control nurse should haver information for discharge teaching for patients with MRSA and other resistant bugs. If not, if your hospital has "Carenotes" that might help, or the CDC website has great information. I don't know if dogs can carry MRSA, but we recently had salmonella that was transmitted via a dog to a little girl, so I guess anything's possible!

We use a different system that is similar to Carenotes, but they don't get really specific beyond simple hand hygeine.

[Larry77, RN]

In my opinion MRSA and VRE are going to grow in commonality whether we like it or not--all we can do is be as careful as possible. We are at risk just like we are at risk for Hep B and HIV. I also think the stigma will die out in the years to come when other even harder to treat "super-bugs" will appear from continued improper use of ABO's.

[redjenny33]

I'm a nurse in Ohio, but I do not work in the ER. My unit gets many MRSA patients though. I recently developed multiple abscesses and was hospitalized. The cultures showed MRSA. I'm wondering if anybody knows if there is a recommended time that I can/should go back to work. Do I need to wait until my 15 days of antibiotic therapy is completed, or just until the abscesses have stopped draining? Any thoughts on this would be greatly appreciated.

[carolg]

I had ca mrsa pnuemonia, It just about killed me. My nurses didn't wear any masks or anything like that, is that normal. I was worried my family might get it. No one else did. I am still very curious as to where I caught it. I didn't work in health care at the time , so maybe the clinic I went to the day before or the vet office? What is the incubation period on this stuff.

[mechai44]

Let me tell you my story, Folks. I worked as an office manager for a pcp practice for adolescents for 5 years. To my recollection we never had a patient with MRSA or even a staph infection cross our threshold. And, as a manager I had little to no physical contact with the patients - no wound dressing, no nothing unless I shook their hand or gave them a hug or something. I am an otherwise healthy 37 year old woman with no chronic conditions. I have never been hospitalized. I have never traveled outside the US (although the CRNP I saw twice in my pcp's office kept asking me that). I resigned my management position a year ago to pursue a nursing degree. In the past 4 months I have had 3 different CA-MRSA skin infections. My physician feels I must be colonized even though my nasal swab came back negative. Add to it that my physician really isn't sure what to do. She's only ever seen 1 other case of MRSA in her practice. I'm assuming then that folks are taking it to the ER's instead. I've done some searching on line to try to better inform myself. Here's what I've learned through my own experience: it's everywhere and getting worse; the decolonization process can include using a product like Bactriban in the nares 2x's day for 10-12 days along with using Hibiclens in the shower 3 days straight all over your body and then 3x's a week indefinitely; Hibiclens is OTC now, by the way; I've been taking Bactrim for the treatment of my wounds which on one hand seems successful but again I'm on my 3rd infection in 4 months so perhaps not; MRSA can colonize in the nares, throat, axillae, and groin. I had my nasal swab done and that came back negative and my throat swab results are still pending. I will tell you that I did the nares Batriban treatment between infections 2 and 3 and still managed to get infected again even though my test results were negative so I'm unclear about it's effectiveness. I have a dear friend who is a physician in Albuquerque and she says they see it all the time. It's just happening and it's going to continue particularly until we get more public information out there for the community to be informed. We need to be able to tell people more than "good hand washing". We need to be able to instruct them about laundering, cleaning their bathroom surfaces or kitchen surfaces, about keyboards and cell phones as potential host sites. There have been some news reports about airplanes, gyms, physicians stethoscopes and grocery store carts being covered with this Superbug. Why then aren't there clearer guidelines out there about how to try to manage it within a persons life? I found your website in search of better information and I'm thrilled I found it! If anyone has any additional info I would be so grateful.

[MassED, BSN, RN]

I haven't heard anything about it. If anyone has some literature i'd love to see it. Are the nurses mostly contracting CA-MRSA or HA-MRSA? I can't imagine it would be hospital acquired.

I can't imagine anyone wants to open up that can of worms... they'll be out of nurses! I don't know of any nurses where I work who have abscesses (that I can see anyway).

[MassED, BSN, RN]

I have been told numerous times by hospital administration that as long as you just follow your precautions you are ok. The problem is I cannot remember an administration that was honest.

I feel and I dont have research to back this up that MRSA in wounds is going to become a bigger problem and it wont just affect those with compromised immune systems. Where I live a few high school football players developed a MRSA skin infection. Also I have read reports of professional athletes and wrestlers developing MRSA.

The problem with healthcare providers is that we dont always know the ones who have MRSA and we have parts of our body that are exposed such as arms, neck, etc. For the past year I have become really concerned about this.

I have thought about it ever since taking Microbiology (pre Nursing) and learning about MRSA and VRE.... scary stuff.