Just diagnosed with MRSA to nares and R foot.....

NurseAlwaysNForever · Sep 25, 2008

Doc called me in to office to say he was sorry, was not MRSA, was garden staff. How nice of him to let me know.

lamazeteacher · Sep 25, 2008

I just received dx of MRSA to nares and to a wound on my R foot. I am taking Bactrim DS 2 tabs PO BID. (3200 mg Bactrim Qd), Bactroban ointment for my foot, and now a nasal spray is being called in. The MD wanted me to come back on Thursday for follow up. I have been off of work the past two days d/t my foot being so swollen. I asked my MD's nurse if it was safe to go back to work tomorrow. She said she would ask the Dr. in the morning. I called my boss to let him know and he said everyone has MRSA in the nares, it's no big deal. Mean while all of my visits from this week have been pushed back and I will have all of them when I return to work, so I need to get back as soon as possible. I can't do a weeks worth of work in one day. Is it safe to go back? I don't want to infect my patients or other staff. Also, how will this affect my husband?
Sorry to sound so retarded, but MRSA is scary stuff to me.

You are right to be frightened - be very frightened! :eek: :eek: :eek: :eek: :eek: :eek: :eek: :eek:

Being off of work is not due to your foot being swollen, it is due to the organism in it.

As a former Infection Control and Employee Health Nurse Public Health Nurse I am shocked that you were told "everyone has MRSA"! You should immediately report your condition (and your boss's statement) to Infection Control and only return to work when the cultures of the affected areas are reported to be negative for MRSA, after correct treatment. Remember that office "nurses" don't exist in most medical offices/ practises these days. Usually a Medical Assistant with a few months' education is there, now.

If you work in a place that is not an acute care hospital, (I suspect it is a Home Health agency) call the County Health Department and report it. MRSA is a "Reportable Disease" (unless for some reason it was taken off the list, but I doubt that).

Hopefully the diagnosis you received followed positive cultures taken of lesions before treatment. Without that, how would anyone know the infections were caused by MRSA? For heaven's sake get a doctor to treat you correctly. The place where you work should pay for that, as long as one of your patients had MRSA. If not, call OSHA! That telephone number should be posted on a visible wall space at work.

By the way, I assume you wear shoes to work. How come you sustained a nosocomial foot infection there? Did you wash your hands to 2 renditions of "Twinkle Twinkle Little Star" before removing your shoes? Shame if you didn't! Or, worse yet, did you scratch your foot somehow before washing your hands sufficiently, and of course afterward? The same preventive procedure is required when you touch/ pick your nose, which is the only way MRSA could have entered your nares! :banghead:

lamazeteacher · Sep 25, 2008

Nice of you to let us know, too. I was pretty upset for you.

By the way, the organism you didn't have is "methacillin resistant staphylococcus aureus". I still wonder how the doctor could say it was "garden variety staphylococcus" without a culture having been taken before he treated it. Or did you have that done? To take a culture, a swab of the lesion is done with a sterile cotton tipped swab from a plastic tube, into which a liquid is released by pressing the sides of it together, then it is sent it to a lab.

NurseAlwaysNForever · Sep 26, 2008

He first suspected that it was MRSA. He put me on the Bactrim and did cultures of my nares at that time. He did not culture the lesion, as it is not draining. He is now saying that it is not MRSA, that it is MSSA by the results of the culture. He has put my on docloxacillin and has me washing with Phisohex, applying bactroban to nares and foot. He has put me out of work the rest of the week and I am to go see him on Saturday morning. If it is not much improved then I will go into the hospital for IV antibiotics. I am a diabetic as well, so it is not healing as it should. He is classifying it as an ulcer. I didn't go to work for 2 days by my own accord d/t the swelling. MD had not put me out of work at that time.

My physician says that I have colonized staff and that is why it is in my nares. I am very adamant about washing my hands. I wash them upon entering and exiting a pts home, and when I get into my car I sanitize them with alcohol gel. I wear clogs, and often while driving I slip them off, however, I do have socks on. I don't wear my shoes into the house, I take them off in the garage and put them on there as well. My physician says that approximately 40% of health care workers are colonized with staff. I am seeing an infection control doctor.

Kabin · Sep 28, 2008

MSRA is becoming more and more prevalent. Estimates of prevalence in hopsitals between 1996-1999 are 40%. That's up big from 1976-1980 where it was