What is the up to date antibiotic use for mrsa ---is there a strict rule as to isolation

[This message has been edited by mischka (edited 03-04-2003).]

Normally, Vancomycin given IV, but this is held in reserve to see if other antibiotics will work first and if resistance occurs with these, then Vancomycin is the final choice.

Also, isolation measures too such as barrier nursing in a side room to reduce the spread.

Thank you so much for bringing this up! My mom has just been diagnosed with MRSA, and because they have had absolutely NO luck with any of the antibiotics she's been on for the past 2 1/2 years, they think it will also turn to VRSA.

I have two main concerns with this...1) how contagious is this from the visitor standpoint, especially children. She wants my kids to visit her, but I am afraid. They already are sick with respiratory infections that don't seem to be getting better,even after over a week. (could they possibly have gotten sick from her room?)

2) She says that the nurses only come in with gowns "sometimes" and no masks. Not sure about the gloves, though. I would hope they're wearing gloves. She had had 2 toes amputated Thursday, and they had to leave the wound open to drain, because of all the infection that had been there from before, even after debreiding it.

Any info is appreciated, as I really don't want to bring my kids to see her if they could get sick (if they haven't already.) She's not accepting my answer to wait a while, as she's used to getting what she wants. (I've always been the rebellious child and not give her what she wants just because she wants it.)

Does anyone have any info on this? I've checked the websites, but they're not specific enough about visiting, especially where children are concerned.

Thanks!
Sue

From a visitor point of view, no it is not contagious, unless you are immunosuppressed for any reason or have open wounds.

Basically, normal healthy adults and kids can not get the infection just through visiting someone who has it. This would mean that all the nurses on the ward would also get it. It has been shown that nurses carry it on their skin and uniforms, however, as long as they wash their uniforms and themselves regularly, it has been shown to be killed off.

As long as your kids are not very young, babies - in which case I would not take them as their immune systems are not well developed, then there should be no problem. If they are normally healthy and have had all the childhood illnesses, then their immune systems will be well developed. It is more likely that they have these colds and such like from other kids at school.

As long as when they visit, they put gloves and aprons on and then make sure that they wash their hands thoroughly afterwards, then this should be ok.

As far as the nurses are concerned, they should be wearing aprons at least. Masks are not necessary, as MRSA is not spread by droplet infection. It is spread by inproper hand washing technique that then spreads from the wounds of one patient to another. Gloves are not stricktly necessary either, as long as the nurse disposes of the apron and washes her hands thoroughly with something such as hibiscrub outside the room before going onto another patient. It is impossible to carry out a log of nursing tasks with gloves on. I always found it impossible to make beds with gloves on.

I think that your kids will be fine, as long as they do not intend to touch any wounds. As long as they wash their hands, they will be fine.

I have to respectfully disagree with the above post.

While the risk of MRSA infection of otherwise healthy visitors is low in certain circumstances, it can never be considered impossible.

"Close contact" has been shown to innoculate nares of nurses and physicians treating MRSA infected patients. Those same staff members go on to innoculate others and is one vector for common outbreaks within healthcare settings. "Close contact" takes on a different meaning when visitors hug and kiss an infected patient.

Current infection control policy within many US hospitals is for "contact isolation," requiring gowns, gloves and shoe covers. Close contact may also require use of facial masks.

Studies are ongoing as to several cases of "suspected" airborne or droplet MRSA transmission, but that vector has not been proven.

I last worked in teaching hospitals in 2000 and have been through many MRSA inservices. Granted, with the proper infection control procedures, the risk of MRSA transmission is low but still present. Many hospitals in the United States are considered reservoirs and despite their best efforts at eradication, patients still get nosocomial MRSA.

My wife's 27 year old best friend acquired nosocomial MRSA during an illness-related hospital stay. She was not immunocompromised. After three years and multiple trials of Vancomycin (other antibiotics too) and multiple surgeries attempting to "cut out" progressively infected areas of tissue, she could not stand the pain, disfigurement and hopelessness and commited suicide. This was especially tragic because she was a nice young lady who very much wanted to get married and have children. Her hopes and dreams were ruined with MRSA consuming her body. She acquired MRSA through no fault of her own...I suppose that is how the cards are dealt sometimes.

As healthcare providers we unintentially trivialize risk by categorizing it as "low." Level of risk doesn't mean a thing once you have acquired an infection.

[This message has been edited by awakatnight447 (edited 05-04-2003).]