MRSA colonization and staff

jmgrn65, RN · Oct 28, 2007

well then there probably wouldn't have anyone left to take care of the patients.

TB tests are just as much for out protection as it is for the patients.

Noryn · Oct 28, 2007

To be honest with you, I dont think anyone does have an answer. We have created this and we have to live with it. The experts years ago claimed that MRSA was really not a threat to "healthy people" and look what has happened.

The bacteria has just adapted and there is no going back 50 years. The reasons for this are not being addressed either. Do you really think doctors and patients come tomorrow morning are going to stop overusing/misusing antibiotics? Just not going to happen. 30-40 percent of the population are now colonized by this according to some numbers. So how do we detect then a better question is how to we "de colonize" these people? Antibiotics? Then you just start the cycle again.

I have also heard that healthcare professionals have up to a 70 percent colonization rate (the number varies), generally in the nares. So do we take this 70 percent and prevent them from working until they care given antibiotics? Is this feasible? One pt could come in and spread the bacteria to 10-15 staff members quite easily. How many patients actually cover their mouths or grab your arms, etc? Also by the time you get the results back, it is 2-3 days later.

It is just a huge mess, but everyone has to realize that the "harmless staph" on our body 30 years ago also was deadly when it was in the wrong place or if our immune system was not working right. We just cannot get rid of bacteria and unfortunately that is what MRSA is.

oramar · Oct 30, 2007

To be honest with you, I dont think anyone does have an answer.
I have also heard that healthcare professionals have up to a 70 percent colonization rate (the number varies), generally in the nares. So do we take this 70 percent and prevent them from working until they care given antibiotics? Is this feasible? One pt could come in and spread the bacteria to 10-15 staff members quite easily. How many patients actually cover their mouths or grab your arms, etc? Also by the time you get the results back, it is 2-3 days later.

I have heard these reasons quoted by others. Somehow, saying we don't want to know the colonization rates because we can't address it directly stikes me as a weak excuse.

angelaQAICnurse · Jan 5, 2008

I hate that we are slowly going back to over culturing. I honestly believe misuse of antibiotics got us where we are today with MRSA & VRE. I work with geriactric residents. The biggest thing I see is we study the effects of meds on peds and adults, but not enough on the elderly. Therefore our Dr's treat our geriactric residents as if they were 40 yrs old. I am finally beginning to see progress being made in this area. Our guidelines are getting tougher in LTC. Many nurses get agrivated with the new changes, but if you really research and read, these are mostly good changes. Finally I am seeing emphasis being put on duplicative therapy, unnecessary medication, polypharmacy. And there is going to be more emphasis on infection control in LTC in state surveys. This makes our jobs harder, but if you look at how our infection rates are rising, you will understand why changes must be made. I still see our medical staff treating colonized infections, and nurses getting phone orders for antibiotics d/t residents showing signs of confusion. These new regs are making us take a step back and think outside of the box. There are other things that can cause confusion in the elderly other than a UTI. Try polypharmacy for one. I will be the first to admit the changes make more work on us poor nurses, but I am sure you all will agree, if you are a LTC nurse, you do it because you love your residents. The one thing everyone should learn about treating infections is the CDC criteria for infections. There has to be signs and symptoms of infection present to classify it as a "true infection." Asymptomatic cultures are a waste of time and money. In my experience, a nurse can culture a geriactric residents urine and it almost always grows out something. Unfortunately, they are almost always treated with an antibiotic because all the MD saw was the C&S. He didn't know that the nurse obtained the culture because the resident had a foul urine odor. This is only one symptom, according to the CDC, it is not a true UTI if you only have one symtom. I wish our nurses could grasp that foul urine odor is also an indicator of dehydration. I have tried to educate my staff about these guidelines. Sadly it is the nurses that have 15 yrs experience with RN degrees that feel like CDC guidelines is not what they should go by. They want to use the "in my experience" card and treat everything with an antibiotic. Sorry to get on a soap box, but I have a hard time getting infection control across to my staff d/t the person that put me in this position loves to write the antibiotic orders. (MY DON) Unfortunately, she is the boss and I will not give up trying to educate her about infection control. I just have to do it very carefully.

Simplepleasures · Jan 9, 2008

Im glad there is already a thread aboust colonization of MRSA in nares of healthcare workers. I would like to know if anyone can enlighten me, or am I just being paranoid and uninformed? My grandaughter has had numerous ear and sinus infections, almost one a month especially now in winter. I dont think they ever cultured her, so I dont know what she has been infected with. I am So paranoid that I may be MRSA colonized and infecting my poor little grandaughter, is this possible? I havent worked for almost two years, but did work for almost 29 years in LTC.Is it possible to infect people we are in close contact with? I try not to give her kisses on her lips, but only her cheek. :confused:

grdmdb · Jan 14, 2008

i have colonized patients who are no longer on isolation- can't i spread this other patietns on the floor? what exactly does colonized mean to other patients?

gina

oramar · Jan 17, 2008

Im glad there is already a thread aboust colonization of MRSA in nares of healthcare workers. I would like to know if anyone can enlighten me, or am I just being paranoid and uninformed? My grandaughter has had numerous ear and sinus infections, almost one a month especially now in winter. I dont think they ever cultured her, so I dont know what she has been infected with. I am So paranoid that I may be MRSA colonized and infecting my poor little grandaughter, is this possible? I havent worked for almost two years, but did work for almost 29 years in LTC.Is it possible to infect people we are in close contact with? I try not to give her kisses on her lips, but only her cheek.

I imagine it is possible that the family member's of colonized health care workers could be colonized also. However, I have to tell you that many, many children have this problem of repeat ear infections without having family members in the healthcare profession. Perhaps the child's parents need to put their foot down with the child's doctor and see some sort of specialist. The poor little thing. Just my:twocents:

Simplepleasures · Jan 17, 2008

I imagine it is possible that the family member's of colonized health care workers could be colonized also. However, I have to tell you that many, many children have this problem of repeat ear infections without having family members in the healthcare profession. Perhaps the child's parents need to put their foot down with the child's doctor and see some sort of specialist. The poor little thing. Just my:twocents:

Hi, thanks for the reply.She had tubes in her ears once already.She's now seven years old, actually she has been seen by an ENT doc and he said to wait and see for a few months, well the ear infections continue, so back in go the tubes and out go the adenoids, hope this works. If she continues to get ear infections after the procedure next week, I will put my foot down and demand they culture her ears and my nares.

elizabells, BSN, RN · Jan 17, 2008

The 100+ nurses on my unit were all swabbed recently 2/2 a huge MRSA outbreak among our patients. Five were positive. Five. Out of (I think) around 120. So don't fret yourselves.

oramar · Jan 17, 2008

The 100+ nurses on my unit were all swabbed recently 2/2 a huge MRSA outbreak among our patients. Five were positive. Five. Out of (I think) around 120. So don't fret yourselves.

Interesting, how did the handle the positives? Did they allow them to continue to work while being treated?

UMSARA · Aug 14, 2008

:specs: :specs: Hello,

I'm a new member ,just joind yesterday I'from kingdom of Bahrain , I was atracted to read this subject, but it add so much for me, I thought we are the onley one who is suffering with resistant organism and peaple, but we were all same,

In my country we will secreen the staff once needed in case of out break , but its not the first measure, as we know that MRSA is communicable, not hospital acquired infection, so its normally to have any staff with MRSA, but being in hospital daily will increase the risk of being colonized of course.

Now adays we have high rate of esbls, which is another big story....

What to do? This is our life fighting organism here and there... :yeah: