What's your opinion: MRSA

[jailside]

How big a problem is MRSA, specifically CA-MRSA (community-acquired methicillin-resistant staphylococcus aureus)? Is your facility dealing with a large number of what's thought to be spider-bites? If you are culturing these abcesses, are they coming back MRSA?

Say that you work in a prison or jail; Are clients with these abcesses being allowed to continue to work? In the laundry/kitchen/what jobs CAN they do?

If you work in the ER, are you seeing an increase in abcesses/boils/cellulitis among otherwise healthy individuals?

What's your opinion? How do we protect the:uhoh21: "worried well"? Are there steps/measures to take {knowing that we can't stress enough, don't share items and HANDWASHING, HANDWASHING, HANDWASHING!} to add a measure of protection and still stay within budget? Are YOU isolating MRSA affected clients:stone ?

And lastly, if you are seeing these affected clients in the ER, are you culturing these abcesses? And if + MRSA/ CA-MRSA, do you offer work restrictions that would affect ther ability to earn $? Where does your average person find the $ to buy expensive dressing supplies to contain drainage?? Thanks

[radiofreak]

:angryfire spiderbites!!! hahahahahaha!!! Oh yes!! these little imaginary creatures are a real pain in the rectum. I work in a small population >300, juvenile facility and if it is not abcesses, then it is ingrown toenails!! Check and see and I will bet that eveyone of these arachnophobes have recieved a new tattoo while incarcerated in the past 6 months. Hmm now I wonder how it is spreading???

[nurseT]

I recently had a case of mrsa. It was a 37 YO non-english speaking hispanic. Through interpretation, he stated he had a spider bite from a black hairy spider and he killed it. That was two days prior to coming for nurses sick call. The bite site was on his rt knee. It had a tiny dried crator in the center and redness surrounding it. The Dr said that was typical of the venom and not to worry. That was on a Friday. On Monday morning when I went in, his leg was red and swollen from mid thigh to mid calf, the tiny dried crator was open and draining. I pressed my hand on his mid thigh and pressed toward the open area, yellow pus and some blood shot from the open area. During investigation, his bunky said the inmate had picked at this area all weekend until it bled. I sent him to ER. Culture came back CA-MRSA. He was treated with outpt IV levaquin BID and oral clyndamycin. He was placed in medical obs cell on contact isolation precautions. 3days later another hispanic inmate had a spider bite on his leg. It was a tiny red bump. No open area, nothing that looked like a boil or pimple. His never developed into anything. I did Notify the county health nurse who stated it does not have to be reported to state. The state health nurse said CA-MRSA is really common, and she worked on the research for an outbreak in a county jail last year. According to her, the inmates were digging holes in their skin and innoculating each other so they could get out. We believed the inmate who had it in our jail came in with it and deliberately aggravated it. I was advised by the state to isolate anyone with any kind of drainage until they are healed just in case. That's what I do anyway.

[Nurse_Peachie]

As long as you have a group of people living in a tight-knit community, there will always be problems with MRSA.

We have had it since last Spring. An IM brought it in from the processing place. We've had it and dealt with it~we have it and are still dealing with it. The IM's are to report to medical via sick call slip and we look at him. The exception to that rule is if they are having drainage, then they are to come straight to medical. We will do a culture, send it to the lab, start them on Clindamycin and put them in the observation cell in medical. In our facility, we are only allowed to keep an IM in medical observation for 3 days.

MRSA can resemble a spider bite. It can start out as a red area, a pimple, or a boil. We tell the IM's not to squeeze it or pop it. MRSA also lives under the finger nails and in the nose. Until MRSA is properly treated, it will continue to reoccur in the person who has it.

Hope that helps.

[indigoskirt]

Thanks for all the info!

[nurse1972]

In our facility we have a large number of documented MRSA but lord only knows how many others out on the tiers undiagnosed.

"Spider bite" is the most frequent complaint and we see those people first in sick call. We do culture wounds if they are draining and place them on Bactrim under "watch take" protocol.

[nurseT]

Well, this thread is 2 yrs old and now I have had more experience with the "spider bite". I have inmates come in now and then already on an antibiotic because they say " a spider or something bit me". When I examine the site, it has all the tell tale signs of CA-MRSA. I've had others who knew they had it. We are DOC holding county jail. Max. I had 1 incidence where 5 DOC ers all came up with a CA-MRSA boil within 2 weeks of each other. All in the same block. It turned out they were deliberately sharing cooties, as they thought it would get them to DOC faster. After I educated the rest of the inmates, they began policing each other. If they saw someone with the tiniest bump, they would hound that inmate until he turned in a medical request or they would write me them selves and tell me to look at him.

[fiestynurse]

Speaking of spiders ---- Some inmates were opening a box of bananas down in the jail kitchen and out crawled a HUGE spider. It was a venomous Brazilian Wandering Spider. They captured it in a jar and some county inspector ran over to get it and seemed quite concerned.

Of course everyone is freaked out - Are there more? Did it lay eggs?

http://www.petbugs.com/caresheets/P-fera.html