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Risk of getting MRSA in children from exposed relatives

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i am really hoping you might be able to provide me with some medical advice I need. My grandmother has been suffering from cellulitis- which we are told was caused by a bacteria that lives on her skin. My mother has for a long period of time been looking after and caring my grandmother. My mother washes my grandmother and her wounds, stays with her at her home, changes her clothes and her bed clothes and does her laundry etc etc. my mother has not taken any precautions and has not been hygienic in caring for her- for example, she does not wash her hands after washing my grandmother or her clothes, she does not wear gloves when touching her wounds etc. we are not sure what type of bacteria it is that is living on my grandmothers skin (i.e. we do not know whether it is MRSA, Staphylococcus or Streptococcus) but we do know that she has had very close contact and has lived with people that have recurring MRSA on their skin and she has not taken precautions around them.
I have twins whom were born prematurely and were very low birth weight when they were born. both twins have very bad eczema all over their skin (they have to have steroid cream treatment for it) and I am concerned that if my grandmother visits us and cuddles my twins, then the bacteria that my grandmother has on her skin may transfer to my twins skin? i am also concerned that the bacteria may have passed onto my mothers skin whilst she has been caring for my grandmother and staying with her at my grandmothers house. Do you consider there to be any risk at all of the bacteria transferring from my grandmothers and/or mothers skin to my twins skin so that they too become carriers of a bacteria on their skins? if so, is the anything we can ask my mother or grandmother to do to completely remove the risk? Should they be tested to confirm whether they are carriers of any of the above mentioned bacteria on their skin (eg MRSA, Staphylococcus or Streptococcus)? And then what can they do to remove it? My twins are at the age where they love to crawl and climb all over people and so they would have very close skin contact with my mother and grandmother if they were to visit or if we were to visit them.


Category: Family Physician-GP

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Dr. Deepu Sebin Sebastian is online now

Expert:  Dr. Deepu Sebin Sebastian replied 4 Days.

With additional inputs from Dr.Vivek Verma (ID).


Hello,

Thank you for asking your query at DoctorSpring.

Human body has a very good inbuilt immune system. That is the reason why your mother is not having any issues even when she is taking care of your grandmother without any precautions.

Your twins also have a good amount of own immunity and protection mechanism (initially from the mother, but later they develop own immunity), but not as strong as a grown up. The fact that they were premature and currently using steroid creams put them into some risk of contracting infections because of low immunity.

So yes, there is a slight risk of infection transmission directly from your grandmother or mother. But this risk not very high or does not require any extreme measures of isolation. The common bacteria which are causing the cellulitis are universal. They are found in many places and even in normal human skin. So an absolute isolation is pointless. Instead some smart and evidenced based precautions will make sense in this scenario.

1. Hand wash – This is the most important single factor that can help in prevent bacterial transmission. Normal intact skin of the baby will not transmit microorganisms. The risk occurs when there is contact with broken skin or wound, eye, nasal mucosa and genitalia. Washing hands prevents this kind transmission. Use a non-touch liquid soap. You can make it a rule (or habit) everyone should wash their hands thoroughly before handling them. You can make this rule universal and say it is needed because of the eczema (to avoid hurting any personal feelings)

2. Cover any wounds with clean sterilised dressing. Open wounds (unlike intact skin) have high chance of getting infected.

4. Testing for carrier state is not necessary. It will not give any actionable information. Even if the tests are all negative you will need to take some precautions. The pus or discharge from the cellulitis should be already tested by your grandmother’s Doctor. Chances are that there could be some antibiotic resistance already. A complete cure of the cellulitis will only eradicate the bacteria. I assume she already had / currently taking antibiotics for this purpose.

4. Reduce the frequency (or even exclude) of the visits to the grandmother’s place until the eczema lesions are healed and dry , with no steroid use.

5. Avoid cross contact with spoiled dresses, dressings, bandages etc.

So In short, some precautions are needed, but no extreme measure per se. As a mother you will have to take charge here and when it comes to child’s health everyone will understand and cooperate. These precautions need to be continued till the eczema lesions heal. (or the cellultits is contained and well treated).

Hope this helps
Please feel free to ask followup queries
Thank you


Dr. Deepu Sebin Sebastian
Category: Select Speciality
Experience: 
MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
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