MRSA (again) and Family Members...Argg

[Penguin67]

Hi all. I posted a MRSA question last Fall and here I am again with yet another question. I have tried, without success, to find an answer online, so please know I did some homework before posting.

How long is one considered contagious following a MRSA infection/outbreak? A family member was recently hospitalized with what was thought to be a spider bite, and found to be MRSA. Three days of hospitalization and IV meds, then D/C-ed home. He works in food preparation at a local restaurant. He was told by the nurse that "the only way anyone could get MRSA from him was if they licked his wound". (Yes, that sounded so professional to me, as well.) Meanwhile, he is still on PO meds and was told to put his old bandages in a sip lock bag when disposing it. (Those last two things tell me that he is still contagious.) I sent the family to many informative websites, including Mayo Clinic and the CDC, to no avail.

I'm not a new grad, have been nursing for 20 years this month, and yet my family insists on listening to this guy talk about how he's not contagious and no one should worry about catching anything. I have a some chronically ill family members (sarcoidosis, immunosuppressed form a liver transplant awaiting on a kidney transplant, heart valve, and others) who probably shouldn't come anywhere near him for awhile, at least until the wound heals over, yet the family prefers to listen to the MRSA person. I am getting a little tired of being ignored by family who are taking medical education from a person who, let's just say has a bit of a past with drugs, alcohol, stealing, jail, you name it.

Anyway, if anyone can assist me with the answser to the bolded question, I would be appreciative! And if anyone has ever had family members want your medical advice, then ignore it because it is not what they want to hear, please send some help this way! I could use it!

Many thanks for listening to my rant.

[PAERRN20]

http://www.goapic.org/MRSA.htm

Very informative website geared towards health care professionals. Hope this helps.

[Penguin67]

Thank you very kindly! I browsed the website and it basically reinforces what I've been trying to get across to some resistant family. They will all have a copy in their e-mail boxes shortly.

[roser13, ASN, RN]

My facility treats all patients with a MRSA history as contagious (infectious disease precautions) unless patient can produce proof of 3 consecutive negative swabs or a clearance from the treating ID physician.

The current problem is that this standard of care is relatively new and patients who were treated for MRSA a few years ago and were assured (at that time) that they were no longer contagious are now required to produce a proof that wasn't required and didn't exist at the time of their infection.

[Gr8Dane]

My impression is that you never get rid of MRSA, you become colonized, inactive.

And I think you are going overboard. Do you think EVERYONE with MRSA should be locked away? Because in that case you best lock yourself up lol.

Truthfully he should keep the wound covered securely and use common sence, good handwashing, etc. If its a wound with a lot of drainage, IE: saturating the bandage, yes he should not work and prob should still be treated.

However if it is not draining why shouldn't he work? Just tell him use good handwashing, keep the wound covered, and do not touch it without scrubbing your hands.

[miss81, BSN, RN]

Is he colonized anywhere else? Like the nares??

[Penguin67]

I don't think I'm going overboard at all. I kept my description of him rather vague, but let's say he wouldn't care if he infected anyone at all, and while he may SAY that he knows the precautions to take, I seriously doubt that he is going to be 100% or even 50% compliant with the precautions. I just do not see him doing any kind of handwashing or disposing of dressings as he should. He was just discharged from the hospital today, and the wound is still wide open.

I thought that once colonized, always conlonized. Glad to see another poster agreeing with that.

No, I don't think that someone with MRSA sould be locked away, but I think we should also carefully analyze how compliant a person is going to be with infection control procedures versus giving them freedom to infect anyone around because they are not being compliant.

(Background here is crucial to understanding my issue with him. He has a strong history of lying, cheating and stealing form his own parents. In other words, the truth doesn't come out of his mouth often. So I don't' trust him at all regarding him saying that he'll do what he needs to do to protect others from getting it. And I don't think he'd feel any remorse if someone else did get it.)

And no ,I don't know if he is colonized anywhere else.

[trixter]

I just discharged a pt who had been admitted for iv antibiotics for a knee wound that tested positive for MRSA per a wound culture. I consulted our hospital infection specialist before initiating "MRSA teaching" because of course, there are questions that are not included in the pamphlet you give the patient. She said that unless the patient has a nasal swab done in the future, there is no way to know if the MRSA is colonized in his body (his wound has healed since admitted) so the following procedures should be followed at home by all family members/visitors as long as the wound is closed/healed: hand washing/sanitizing, wiping counters/surfaces with Lysol-like products, washing linens and towels in hot water, and pt to use tissues after sneezing/coughing. She said MRSA is fairly easy to get rid of with these precautions and that they are precautions that are good for even non-MRSA households to follow. Of course, as I walked him out, he asked if he could use his hot tub. I told him that he should make sure that the wound is totally healed (as in, you don't see evidence of it). I wish I had more time to research that, but it sounded like a common-sense answer. I suppose he could seal it, or hang his leg out of the tub...Didn't think of that until now. Oh well.....

[Gr8Dane]

Look at it this way, the majority of health care workers (Doctors, nurses, diagnostics, etc) are colonized with MRSA in the NARES. You can treat it with bactroban twice daily for a week and clear it for a short while but it almost always comes back.

Also look at all these patients who come in with MRSA, then leave. It's still there, it will most likely never be "cured" until new antibiotics are created.

The above are at Walmart, shopping malls, restaurants, using the bathrooms, touching the products, counters, currency, etc.

Simple fact is MRSA is beyond our control in and out of the hospital. We can only attempt to manage it in doors and teach as much as we can, beyond that people must live and are not going to change there lives over something so broad anymore.

[dishes, BSN, RN]

the guy handles food and doesn't wash his hands, MRSA or not, the poor hygiene presents a public health risk... if you submit a complaint to the department of public health, they can send an inspector to his workplace, bet it will change his attitude about handwashing, if he thinks he lose his job.

[DolceVita, ADN, BSN, RN]

I had a serious MRSA infection. Just had knee surgery and they actually assumed that I was colonized with it. I was negative with a nasal swab years ago but the infectious disease doc says that recolonization is "extremely common" and they will always assume that I am recolonized unless proven otherwise. He gave me a couple of articles but I have long since lost them.

By the way he did not go spare about me going back "into the community". I got the bloody thing in the community after all.