Re: Mrsa

If you have an active infection then yes you can get rid of it. For instance if you have it in your bladder, take antibiotics it will likely go away. If you are colonized with it, then it depends. Antibiotics may get rid of it, your body can also get rid of it over a period of weeks/months.

MRSA goes away with treatment, the media makes it like it will never go away. But there are antibiotics to get rid of it. VRE is less likely to go away.

I have a question. We had a two patients on our floor at the same time, both with mrsa in their sputum. One was on isolation the other was not. Why? The one that was I did not take care of so I do not know the specifics. The one that was not, was a COPD'er, and ESRD on dialysis in the same room as a fellow ESRD on dialysis. He was on doxycycline for his infection however. Is that why he was not isolated? I just think that is bad practice to have those two in the same room. I know some hospitals do not isolate for MRSA anymore. I just don't understand the reasoning behind why one patient would be isolated and the other would not.

MRSA colonization usually occurs on the skin, in the nose, or in the mouth (same as any other staph species). For surveillance, we will typically do groin, armpit, nares, and occassionally throat cultures. It is possible to decolonize a person. We use the following procedure.

1) Daily full body wash with chlorhexidine soap, wil special attention to the groin, armpits, or any other skin fold area.

2) Bactroban 2% topical to both nares bid (and you have to really rub it in there for a good 30-45 seconds).

3) Peridex (chlorhexidine) mouthwash swish and spit bid (again, it has to be a good 30-60sec to be effective).

It doesn't always work, but sometimes it does. I have also heard of giving rifampin, but personally don't do this (risk vs benefits doesn't add up favorably in my mind).

If they are colonized but not showing signs of infection, attempting to 'decolonize' only increases the chances of more resistant strains. We used to screen and then treat all colonized patients with nasal bactroban, but that's not done routinely any longer (can't remember the last patient with that ordered...several years, at least).