Having a hard time understanding MRSA......

Posted

Ok, so I know someone can get "colonized" with MRSA and it can be found out by swabbing their nares. Many of us nurses are probably MRSA positive if we all got swabbed. My question though, is what exactly does this mean? How would we infect others or become infected ourselves if it is in our nares? If we touched our nares, and then touched one of our wounds, would we infect ourselves with MRSA in the wound? I'm SO confused!!!

xtxrn

xtxrn, ASN, RN

4,266 Posts

Ok, so I know someone can get "colonized" with MRSA and it can be found out by swabbing their nares. Many of us nurses are probably MRSA positive if we all got swabbed. My question though, is what exactly does this mean? How would we infect others or become infected ourselves if it is in our nares? If we touched our nares, and then touched one of our wounds, would we infect ourselves with MRSA in the wound? I'm SO confused!!!

The bugs are present, but not in enough quantity to cause an infection. They're "camping" without infecting.

Yes you can infect an open wound if you play with your nose, and then touch an open wound....:eek:

http://goapic.org/MRSA.htm

2011nursetobe

2011nursetobe

64 Posts

Thank you...great link!

Ok, so I know someone can get "colonized" with MRSA and it can be found out by swabbing their nares. Many of us nurses are probably MRSA positive if we all got swabbed. My question though, is what exactly does this mean? How would we infect others or become infected ourselves if it is in our nares? If we touched our nares, and then touched one of our wounds, would we infect ourselves with MRSA in the wound? I'm SO confused!!!

We all have S. aureus on our skin, but some strains of it are resistant to certain antibiotics (MRSA). Handwashing is your friend. Getting MRSA in a wound may or may not lead to infection with the organism. It depends on how many organisms were transferred, and how strong the person's immune system is, among other things. It's like any other opportunistic bacteria: if it can gain a foothold and multiply, it will. If an infection occurs, however, it's just harder to treat because only a limited number of antibiotics will affect it.

Best thing to do? Wash your hands!

kaliRN

kaliRN

149 Posts

Thank you to the OP for posting this, I think a lot of us new (and even seasoned) nurses have difficulty understanding the aspect of "colonization." I almost posted this last week having my first experience with this in the home environment, but found some great articles. I enjoyed the one shared by xtxrn.

Great link posted xtxrn. Here's a great brief summary of colonization from there:

"It is important for the health care professional to understand the difference between colonization and infection. Colonization indicates the presence of the organism without symptoms of illness. Colonization can occur in the nares, trachea, skin folds, rectum, or in an open wound such as decubitus ulcer. The patient does not symptoms when colonized. 70 % to 90% of all individuals are intermittently colonized with S. aureus (methicillin susceptible or resistant) in the anterior nares. S. aureus permanently colonized the anterior nares of about 20% to 30% of the general population. Hospital workers are more likely to be colonized than persons in the general population, presumably because of increased exposure. Thus, a higher colonization rate with S. aureus is responsibility of the physician to determine if a patient is colonized or infected. Colonization with MRSA is not an indication for hospital admission or for prolonged hospitalization provided appropriate arrangements for disposition can be made (e.g. discharge to home or extended care facility)."

I have had nurse friend's of mine refuse to be swabbed in the ER because they didn't want "history of MRSA" permanently included in their medical record. I'm not here to discuss whether that's right or wrong, but I think understanding colonization in those percentages makes it clear why this may be a very valid concern.

nerdtonurse?

nerdtonurse?, BSN, RN

Specializes in ICU, Telemetry. 3 Articles; 2,043 Posts

What saves most of us is that MRSA isn't seriously virulent like strep milleri (commonly seen in necrotizing fasciitis). MRSA is a bacteria, under specific conditions it can make you sick, but it doesn't make everyone who's colonized sick.

The two biggies about a bacteria are virulence and infectivity -- how sick does it make you and how easily is it spread. If MRSA was a virulent as Strep milleri, but as infective as campylobacter (the reason you get GI upset after eating at a buffet), this world would be a much emptier place.

Over time, a bacteria's genes experience drift and shift -- this is why something that at one time killed millions (like the Black Death, which may have been viral, bacterial, or two bugs dancing through the population at the same time) "burned itself out" -- the bug experienced enough drift or shift to the point where it was not as infective and/or not as virulent.

I suddenly have the overwhelming urge to go wash my hands....

Isabelle49

Isabelle49

Specializes in Home Health. 849 Posts

MRSA is bad news. I don't know that I have ever been colonized with anything. Many years ago a nasal swab X 2 came up sterile. Staff had to have hands and nares cultured before working with open heart patients.

Earlier this year I developed MRSA in 2 locations in my right armpit requiring I & D's. I also had pretty bad cellulitis along with this. Was on 3 different antibiotics and couldn't work for 2 weeks. Nasty, nasty bug, very very painful infection.

OneOfTheGoodGuys

OneOfTheGoodGuys

Specializes in Adult Medical, Home Health. 11 Posts

Generally, I live by a couple rules that I feel transcend all other policies in place by hospitals, laws in place by governments, protocols, agendas, etc. One of those cardinal rules is this: it is never a good idea to wipe boogers into open wounds.

(This post was made in humor, with no intention of trying to be demeaning or offensive to the OP I just had to say it because its hilarious to me)

OneOfTheGoodGuys

OneOfTheGoodGuys

Specializes in Adult Medical, Home Health. 11 Posts

P.S. Also not trying to downplay the seriousness of MRSA. It is a horrid little bug that is notoriously hard to treat and is very common, and I have been told it is very painful. Once again the image of someone wiping a booger into their wound just makes me laugh, because I am actually a 12 year old stuck in a grown ups body. Apologies to anyone this offended, that wasn't my intention.

treysdaddy08

treysdaddy08

190 Posts

I seriously want to make that my tag on...everything! now. Lolololol!!!

treysdaddy08

treysdaddy08

190 Posts

Still rotflmao...

treysdaddy08

treysdaddy08

190 Posts

Still rotflmao...hilarious!