Is it really MRSA?

14 I lifted this quote from a closed thread to clarify a point made (which was not related to the reason it was closed).

" First, you don't find "MRSA" in the stomach, well you sort of do in that all enterococci are resistant to the methicillin family, but it's not the same as "MRSA". Everyone is colonized with bacteria, and if some of that bacteria is resistant to methicillin antibiotics then we call it MRSA, but that doesn't mean that someone is oozing MRSA out of every possible place in their body, and it's actually usually localized; in a wound, in the sputum, in skin folds, etc. MRSA infections are treated, simple colonizations or getting some MRSA on you, or even in your eyes, should not be treated with antibiotics."

MRSA stands for "methicillin-resistant Staphylococcus aureus," and not anything else. An enterococcus is not a staphylococcus. We don't call anything that's methicillin-resistant "MRSA." Calling anything that's resistant to methicillin "MRSA" is inaccurate and misleading, and bespeaks an indication to go back to your micro textbook for a refresher. Here's a good article that also clarifies what's infection and what's colonization, and how that works specifically in people with MRSA.

http://www.nfid.org/content-conversion/idarchive/staph.html

Furthermore, recent research indicates that swabbing nares with mupirocin (Bactroban) for every patient in the ICU, without regard to whether cultures were done or not, reduced the number of MRSA infections in the unit as a whole. So yes, prophylaxis is becoming standard in those settings.
Thank you! I was really biting my tongue (fingers?) over that one.

Thanks for posting this. There is a lot of misinformation about MRSA, even among healthcare providers. In our ICU we do a nasal swab to test for MRSA first and, if positive, the patient is treated with Bactroban to the nares twice daily for 5 days and then re-tested. I think the reason we don't just treat everyone is because kids generally get very PO's when you try to stick stuff in their nose.

I actually had a long post lined up for that thread and then it was closed before I could post. Anyway there are a number of resources out there including the CDC. CDC - Methicillin-resistant Staphylococcus Aureus (MRSA) Infections Sometimes it seems like people are either completely scared of it or completely ignore it all together.

Quote from GrnTeaI lifted this quote from a closed thread to clarify a point made (which was not related to the reason it was closed)." First, you don't find "MRSA" in the stomach, well you sort of do in that all enterococci are resistant to the methicillin family, but it's not the same as "MRSA". Everyone is colonized with bacteria, and if some of that bacteria is resistant to methicillin antibiotics then we call it MRSA, but that doesn't mean that someone is oozing MRSA out of every possible place in their body, and it's actually usually localized; in a wound, in the sputum, in skin folds, etc. MRSA infections are treated, simple colonizations or getting some MRSA on you, or even in your eyes, should not be treated with antibiotics."MRSA stands for "methicillin-resistant Staphylococcus aureus," and not anything else. An enterococcus is not a staphylococcus. We don't call anything that's methicillin-resistant "MRSA." Calling anything that's resistant to methicillin "MRSA" is inaccurate and misleading, and bespeaks an indication to go back to your micro textbook for a refresher. Here's a good article that also clarifies what's infection and what's colonization, and how that works specifically in people with MRSA.

Quote from GrnTeaFurthermore, recent research indicates that swabbing nares with mupirocin (Bactroban) for every patient in the ICU, without regard to whether cultures were done or not, reduced the number of MRSA infections in the unit as a whole. So yes, prophylaxis is becoming standard in those settings.

I contracted MRSA after fracturing my right femur. It was a closed fracture, but, without hesitation, everyone I asked where I contracted the infection said, "the hospital". I had five surgeries at the same facility: one to place the plate and screws, three to clean out the infection, and one to remove the plate and screws. I was on IV Vancomycin, and developed a beautiful 'red man's syndrome'. I was in an extended care facility from March until mid-August. Was ambulatory with a walker, but the osteomyelitis returned. To make this story short, I ended up at a major medical center for a transfemoral amputation of my right leg. Subsequent nasal-pharyngeal swabs have indicated a colonization of MRSA. What upset me the most, was being treated like a 'rotten piece of meat.' I think medicine, AND nursing needs to do more to support patients emotionally when they are going through this type of process. As a nurse myself, I knew probably what needed to be done, but I very much needed some more TLC to get through this situation.

Finn55, sorry to hear about your health struggles. That sounds like a terrible series of events. I'm sorry that you weren't treated with all the kindness and compassion you deserved. I hope you'll use your experiences to educate us on what works in therapeutic communication. Thanks for sharing and reminding us that MRSA (often ignored as another familiar hospital acronym) is not something to take lightly.

Quote from MunoRNI thought the "but it's not the same as MRSA" statement of that post was pretty clear. You'll notice I specifically distinguished "enterococci" from staph aureus. I only clarified that MRSA and enterococci aren't completely different in that enterococci are typically also resistant to methicillin.

Quote from GrnTeaI was referring to this:"Everyone is colonized with bacteria, and if some of that bacteria is resistant to methicillin antibiotics then we call it MRSA, but that doesn't mean that someone is oozing MRSA out of every possible place in their body, and it's actually usually localized; in a wound, in the sputum, in skin folds, etc."Wrong-o. Not all bacteria are Staphylococcus. Sorry I didn't make that clearer.

Out of curiosity...our hospital, once you test positive for MRSA or VRE, you are always considered positive. I know that not all hospitals do this, and I think it might be expensive and redundant. What do you all think? When my Dad was positive for both, the hospital (many states away from mine) policy there was that if you had 3 (weekly I think) negatives, you were considered "clear".Very interesting also, about the prophylactic treatment. I don't think we are doing that but you can bet I will be asking our Infection Control...

Quote from arrisubOut of curiosity...our hospital, once you test positive for MRSA or VRE, you are always considered positive. I know that not all hospitals do this, and I think it might be expensive and redundant. What do you all think?

That sounds much more reasonable. If you had MRSA 10 years ago...and you came to my hospital...you would be put in precautions. I think your way is better!