MRSA question

jaimemds · Apr 17, 2005

A lot of infectious disease MD's rely on sed rates

redwinggirlie · Apr 17, 2005

Nasal swabs, wound cultures are good ways to discover MRSA

CapeCodMermaid, RN · May 1, 2005

I'm pretty sure that if you cultured YOUR nose, or mine for that matter, you'd find MRSA. It's everywhere...another good reason to maintain universal precautions.

sbic56, BSN, RN · May 1, 2005

I'm pretty sure that if you cultured YOUR nose, or mine for that matter, you'd find MRSA. It's everywhere...another good reason to maintain universal precautions.

MRSA, while not quite as prevalent as you suggest, certainly is on the rise. This was the best study I could google up on MRSA in the general population, though it is a couple of years old. Still, I thought it was very intersting and informative.

http://www.cpsp.edu.pk/jcpsp/ARCHIEVE/Nov2004/Article6.pdf

nurse4theplanet, RN · May 1, 2005

I'm pretty sure that if you cultured YOUR nose, or mine for that matter, you'd find MRSA. It's everywhere...another good reason to maintain universal precautions.

I knew that S.aureus was everywhere, on our bodies, etc. but I had no idea that MRSA was everywhere and on us all the time.... are you sure that's right b/c it was my impression that this resistant strain caused terrible infections in anyone who became infected with it. I had a poor lady come down with it the other day and we not only used universal precautions but also isolation precautions as well. Can't be as common as your suggesting....

Guest70758 · May 1, 2005

My clinical site runs rampant with MRSA and C. diff. Our instructor told us that now, after a semester in the hospital, we all probably have it colonized in our nares. While being colonized doesn't mean that you are infected and will be symptomatic, it can cause an increased risk for post-op infections in the future.

I don't know much about MRSA either, and besides the risk for post-op complications, I don't know the long-term implications of being colonized. If I am hospitalized in the future, are my chances much higher of being infected wiht MRSA, or of devloping sepsis?

sbic56, BSN, RN · May 1, 2005

My clinical site runs rampant with MRSA and C. diff. Our instructor told us that now, after a semester in the hospital, we all probably have it colonized in our nares. While being colonized doesn't mean that you are infected and will be symptomatic, it can cause an increased risk for post-op infections in the future.
I don't know much about MRSA either, and besides the risk for post-op complications, I don't know the long-term implications of being colonized. If I am hospitalized in the future, are my chances much higher of being infected wiht MRSA, or of devloping sepsis?

To give you an idea of how one can go from being colonized to being actively infected/symptomatic, here's a story from one of my nurse peers: She works med/surg, sometimes taking care of active MRSA patients. She went for a hysterectomy and developed active MRSA at the op site. She did not know she was colonized prior surgery. She was fine until placed in a vulnerable state, ie, an open surgical site, lowered resistance.

DAREINGTX · May 1, 2005

sbic is correct. i recently read an article that said you could lower

your "bacterial load" by soaking for 30 min in a bath with 1/2 cup

of bleach. there are other tx i have heard, but don't recall specifics.

madwife2002, BSN, RN · May 1, 2005

We swab all our patients on admission for MRSA we swab their nose and groin, and if they have an open wound we swab that as well. If a patient is transfered from another hospital we will swab iv access sites, peg sites ect. If found positive we use a 5 day protocol which means we use bactroban nasally and they bathe 2 x Daily in hibiscrub, then 3 days post treatment we reswab to check status. MRSA usually only becomes a problem if there is a breakdown in skin integrity, or open access. Yes you are right we all carry s auerous on our skin it lives there quite happily until there is again open access, ie iv sites.

sbic56, BSN, RN · May 1, 2005

We swab all our patients on admission for MRSA we swab their nose and groin, and if they have an open wound we swab that as well. If a patient is transfered from another hospital we will swab iv access sites, peg sites ect. If found positive we use a 5 day protocol which means we use bactroban nasally and they bathe 2 x Daily in hibiscrub, then 3 days post treatment we reswab to check status. MRSA usually only becomes a problem if there is a breakdown in skin integrity, or open access. Yes you are right we all carry s auerous on our skin it lives there quite happily until there is again open access, ie iv sites.

I see you are in UK. I have not heard of precautions such as you describe used in the US, but maybe someone here can clarify on that. About what percentage of those you test upon admission test positive for colonization? Do you keep those who colonize positive isolated from the rest of the patient population? If so, do you lift precautions after treatment and the second swabbing?

hollyster · May 1, 2005

I'm pretty sure that if you cultured YOUR nose, or mine for that matter, you'd find MRSA. It's everywhere...another good reason to maintain universal precautions.

You are right. One of our ID doctors has told us for years that "every nurse that works more then a month in a CCU is colonized with MRSA and VRE." :uhoh21:

He is now the head of the infectious disease center for the state.