MRSA colonization question

[AnnaN5]

I had a MRSA skin infection ~2 years ago that cleared up in about 1 week and has not been a problem since. Ever since then I have been tagged by my pcp's office as a MRSA patient and they have to follow special protocol whenever I have an appointment for anything. I had a physical for nursing school earlier this week with my pcp and she suggested I get a nasal swab done so I could possibly get off the MRSA list.

Well today one of the office girls call to tell me my nasal swab came back positive for MRSA and that if I want to get on antibiotics I need to make an appointment and my pcp will write me a prescription. This is where I got confused.

During my physical when my pcp was talking to me about the nasal swab she said something about how the vast majority of the dr's and nurses in that hospital would could back positive if they had a nasal swab done. I remember reading back when I first was researching MRSA that a certain % of the healthy population has MRSA colonized in their nares. Just now when I did some more research, I came across this:

"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."

So if that is true why should I go on antibiotics just to try and get rid of it if it is not a problem? Should I do it because it could be a problem during clinicals if I am around immunocompromised patients?

I hope this isn't breaking the rules about getting medical advice. I just know there have been a few discussions on here before about MRSA. It seems like if that large of a percentage of people have MRSA colonized in their nares that it would seem pointless to go on antibiotics if you are asymptomatic?

[puggymae]

MRSA is so rampant that I am sure that alot of health care workers do test positive on a nasal smear. My gut instinct would be to call the infection control nurse at your local hospital - that is who I call anytime I have a question about MRSA - or any other infection a student might have or might have been exposed to. That person will be up to date on the latest info and treatment. MRSA isn't just hospital acquired any more, community acquired is raging in my community at the present time. Wish I could be of more help, and I hope you find some answers. Let us know what you find out.

[Tweety, BSN, RN]

I think if the colonies are below 50,000 (don't quote me on that) we don't give our patients antibiodics but just give them bactroban to their nares.

If they are greater than 50,000 we don't consider them "colonized".

If I were you for the sake of your future sick patients, the 70 to 80% of them who aren't colonized, I would at least go with the bactroban on the nares, rather than p.o. or IV antibiodics. I'm not sure how much that helps however.

Good luck!

[AnnaN5]

Thanks for the help! I am going to try to get ahold of the infection nurse. The whole ordeal has not been easy because it seems like my pcp never has answers for my questions and just wants to put me on some antibiotics.