MRSA in the NICU.....question for you

fergus51 · Apr 22, 2005

Contact isolation and scrubbing. Nothing high tech.

Gompers, BSN, RN · Apr 22, 2005

Contact isolation and scrubbing. Nothing high tech.

Same here. Babies who are MRSA+ (or whose parents are known to be MRSA+) are put into contact isolation. That's all.

We just started swabbing every baby upon admission, and once a week after that. It's new for us, but we're happy that only a couple of kids at a time are ever positive, and it's almost always found that the parents are postitive as well. We don't swab the staff, do you guys?

We had one baby, a while back, get Bactroban cream. It was swabbed in her nares a couple times a day, until she came back with three negative MRSA screens in a row. Why we don't still do that, I dont' know.

BittyBabyGrower, MSN, RN · Apr 22, 2005

We just had an outbreak...yuk. We swab all the kids in the unit, nose and umbilicus. We contact isolate the kids in one room...gown, gloves, good scrub.

We were all swabbed as a group one time because we had such an epidemic of it! All people that were positive had to put the bactroban up the nose and were put in the MRSA area until they cleared. That was one ugly time in our unit!

NoCrumping · Apr 22, 2005

Never had MRSA in our NICU..... (yet)

sparkyRN · Apr 22, 2005

We are going through it now. Babies are swabbed on admission and M-W-F. Any baby that is colonized is placed in the isolation room (luckily it is pretty big...there were 12 babies in there yesterday.) RNs and NNPs assigned to that area wear hosp. laundered scrubs, use isolation gowns and gloves with each pt. contact and are not allowed in the regular unit during that shift. I.C. is in the process of swabbing all the nursing staff and those positive will be "treated confidentially." MRSA group isolation has been going on now since about the first of the year and there is no let-up in sight. Parents are not being swabbed, neither are residents, staff MD's or the legions of ancillary personel that file through there everyday. Our general population is said to have a high colonization rate in the community so I can't imagine this is ever going to end. Fortuantely, I'd like to add, that actual infection rate-skin lesions or sepsis- is very low. 4 or 5 of the dozen or so actual cases since last summer were transferred in with it.

BittyBabyGrower, MSN, RN · Apr 22, 2005

Sparky...everyone, including secretaries, docs, ancillary got swabbed. It was horrible. Right now we have 8 kids with it. It seems to go in cycles, esp when we get docs from other hospitals in. Hmmm..wonder if their is a connection?

MistyKat10 · May 12, 2005

Currently in our NICU we swab every baby on Mondays. The staff are swabbed about one time a month. If a baby is pos. then we wash them with hibiclens baths every other bath for three baths and use the bactroban in their nares for five days twice a day. We also isolate them for contact isolation and wear gowns and gloves. Very few of our babies get septic from it and I believe some of it is overkill. MRSA is so prevalent in the communities now it's something that will never be rid of. We do go through spurts of MRSA. Sometimes we have none for months and then all of a sudden we have a huge outbreak with 10-12 babies. For awhile the nurses felt like we were being blamed for the outbreaks. Seems every time there is one they come down hard on us for universal precautions and hand washing which we all do all the time.

Natalieboo · May 15, 2005

Sorry, just a curious reader... what does MRSA stand for?

Thanks! :)

BittyBabyGrower, MSN, RN · May 15, 2005

Methicillin Resistant Staph Aureus

kitty29 · May 15, 2005

Hi all,
I'm curious how you go about protecting yourselves in caring for babies who test positive for MRSA. A friend of mine works in a NICU that just had a huge outbreak....sounds like chaos.
Anyways, what have you seen in terms of MRSA in your respective NICUs, and what do you do to prevent yourself (other than the standard universal precautions), and the other patients?
Thanks for your help!

Boy that's a big deal, and we have had this happen twice over the last 5 years. First we call for an ID consult. We allow no admits into that room. Our NICU is 4 rooms with 6 to 8 babys in each room. The ones that are positive are all under strict isolation precautions. Everyone in the room is cultured and the parents are called by the consultants. The baby who is positive is treated and has to have 2 neg. cultures before the isolation precautions can be discontinued.

We routinely do cultures on all babys who have central line every monday now.

When this first happened everyone of the staff was also cultured and anyone who was positive was treated ---had to be treated for 3 days before working again.

NOT FUN!!!

sparkyRN · May 15, 2005

It is actually highly colonized in some populations. Many people have the bacteria without having an infection. It is often found in the nasopharynx and on the skin. The problem with it is that it is easily spread by contact and if a suseptible patient becomes septic with it, they can become fatally ill. The only treatment (that I know of) is IV vancomycin.