Know how long a MRSA pt. is infectious?

[beachmom]

If someone has strep throat, they are given antibiotics. After they take antibiotics for 24 hours, they are considered not infectious and can be around people.

I have noticed that a MRSA pt. may be in the hospital a week or two, and they are with MRSA precautions the whole time. They may have started on Vanco their first day, but they never get out of precautions. How long does it take to rid a person of MRSA? They go through all their MRSA precautions at the hospital, and then they are discharged with no warnings to protect other people other than "wash your hands."

When a treated MRSA pt. goes home, does their family have to worry about getting MRSA???

Thanks for any info you might have on this subject.

[AJPV]

I think patient response to MRSA treatment is extremely variable from one patient to another. There are lots of variables involved - the patient's immune status, the particular strain of MRSA and the strain's susceptibility to Vanc, the particular site or sites of infection and the likelihood of the MRSA cells being able to hide (sequester) themselves at that site, etc. That's why some patients can be "cured" relatively quickly while others seem to be colonized for life despite repeated antibiotic treatments. I think the only way to know a patient can be taken off of precautions is be having a series of tests come back negative. Anyone know what the usual protocol is for that - is it 2 negative tests in a row?

[roser13, ASN, RN]

My facility's policy is one negative culture - used to be 2 consecutive tests. However, the truth is that very few MRSA patients (or their doctors) follow up very efficiently. MRSA patients (in my experience) hardly ever obtain a culture after treatment. So we (ASC) likely overdo the isolation of former MRSA patients simply because we don't have evidence to support the discontinuation of the isolation protocol.

[loriangel14, RN]

They are usually considered infectious until the have a negative culture.Many people end up colonized and we will never swab negative.LTC facilites where I live no not isolate for MRSA as most of the popualtion (and staff? lol) are colonized.

[Reno1978, BSN, RN]

There should be a P&P at your facility for removal of isolation precautions for these patients. Where I work, it's basically that you need a negative culture after the patient has been off abx for 72 hours, which is difficult because almost every ICU patient is on some abx.

[beachmom]

Thank you all for your replies. I wish the medical system would come up with better answers. We don't usually test them before they go home to see if they are negative, so we are probably often sending MRSA pts. out the doors to hug babies, touch grocery cart handles, etc. Not very comforting.