ER Nurses contracting MRSA

MassED, BSN, RN · Jun 23, 2008

At a prior hospital I worked at a nurse contracted a deadly form of CA-MRSA and went to the er to get checked out before going home sick from the night shift. Everything checked out ok, his chest films, labs etc. By 0600 he was back in the ER in resp distress actually went to the MICU where he later died a couple days later. Rumor has it that 2 other people got sick also but because they had been exposed more that it did not effect them as much. The nurse that died was a new grad actually in my hospital orientation class and because he was not exposed and was a younger kid made him more likely to do bad with this particular form of MRSA. So be careful out there!!!

He had MRSA in the lungs? That is awful.... and from what I have heard, that is unusual to be in the lungs and not a good prognosis.

MassED, BSN, RN · Jun 23, 2008

Be very aware of patients who come in with 'spider bites'. We just discharged a guy who had 'spider bites' all over his body. They all cultured MRSA(ca) pos.
My SO has had many MRSA infections. They come on fast and get worse quick. They are very painful. The last time he was infected they ended up doing an I&D in the OR. Treating the infected patient can only be part of the cure. The family must be treated prophylactically with bactroban oint nasally and PR BID.
This is really scary stuff.

I use Bactroban for any open wounds in my house ... my kids' pediatrician recommends it as well.

MassED, BSN, RN · Jun 23, 2008

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.

That is irresponsible not to culture wounds that are treated as MRSA. What about infection control follow up? And treating with antibiotics, you have to think about mutation and god knows how many other forms of MRSA are out there.... It's too scary to think about!

MassED, BSN, RN · Jun 23, 2008

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.

And to think people would make fun of me when I would use hand sanitizer on the grocery cart handle (and not let me kids touch doorknobs), now there are "courtesy hand sanitizer wipes" where I go to the grocery store. Now if they could just stop the bugs in the air! I just hope most of us can stave off this bug not only with good handwashing, but with strong immune systems to then build better immunity.