MRSA STAPH INFECTION with no improvement on antibiotics.

Thank you for your query at DoctorSpring.com.

Dear parent, I do understand that she has a boil. However, I would like some additional details.
- What is the location and size of the boil?
- Is she also running fever?

- Is she toxic/looking unwell?

- Is she having her feeds?

- Is she having any other symptom?

- Did you get a swab culture from the swab? Has it grown MRSA?

- Why do you suspect that we are dealing with a MRSA infection?

- What antibiotics is she on? Oral or intravenous/intramuscular route?

Please reply to the above questions in the follow-up.

Regards, Dr. Saptharishi L. G.,
Consultant Pediatrician.

doctor thank you for your teply. My wife does in healthcare and we believe she could've brought mrsa home from a patients. No addition symptoms no fever eats well goes to the bathroom well has been cultured. You couldn't tell anything was wrong with her unless U see the boil in her stomach.

Thank you for your query at DoctorSpring.com.

Dear parent, I do understand that she has a boil. However, I would like some additional details.
- What is the location and size of the boil?
- Is she also running fever?

- Is she toxic/looking unwell?

- Is she having her feeds?

- Is she having any other symptom?

- Did you get a swab culture from the swab? Has it grown MRSA?

- Why do you suspect that we are dealing with a MRSA infection?

- What antibiotics is she on? Oral or intravenous/intramuscular route?

Please reply to the above questions in the follow-up.

Regards, Dr. Saptharishi L. G.,
Consultant Pediatrician.

doctor thank you for your teply. My wife does in healthcare and we believe she could've brought mrsa home from a patients. No addition symptoms no fever eats well goes to the bathroom well has been cultured. You couldn't tell anything was wrong with her unless U see the boil in her stomach.

Hello,
I must really appreciate the fact that as parents, you are doing your best. You thought of a Methicillin-resistant Staphylococcus aureus abscess because one of you is a healthcare worker. Logical thinking. Appreciate your presence of mind. However, I think we are assuming a lot of things here. MRSA staphylococcal abscess is uncommon and unlikely. Out of all skin-soft tissue infections among children of healthcare workers, less than 0.01% is due to MRSA. May be even lesser.
Please provide information regarding size of the abscess and antibiotic that your child is on.
If there is a small boil, we need to do nothing. Just keep a close watch. It is important is to drain the abscess (in a hospital setting by a physician) and apply topical antibiotics. Even oral antibiotics may not be required of the boil is small. Give her plenty of fluids. Encourage hand-hygiene as well as other personal hygiene measures.
Regards.

Hello doctor, my daughter finally faught the infection and all abcess are no gone. She did have mrsa, she was screened last week and results came in yesterday. My question is, now that she shows no signs of boils or infection, is she contagious? What life changes do we need to do ? And is she contagious only in an outbreak ? Or is she contagious for the rest of her life? Can I decolonize the infection in any way ? Thank you doctor for all your help it is greatly appreciated.

Hello,
MRSA can colonise nares, oral cavity, gut, skin, etc.. A systematic decolonisation protocol involves mupirocin ointment for nose, chlorhexidine mouth wash and chlorhexidine body wash (soap) for at least 5 days. It is possible that your spouse as well as the child are colonised. It is better to go ahead with swabbing the two of them - meaning sending culture samples from nares, mouth, skin, etc to check for MRSA colonisation. Subsequently they can undergo the decolonisation protocol and thereon, repeat the cultures to see if the MRSA is gone. Having said that there is no real consensus on how to manage a community carrier of MRSA even among experts.
Also important is good hand hygiene. After your spouse returns from the healthcare facility, she should wash her hands with chlorhexidine and only then touch the child. Improving general hygiene precautions may help.
Regards.