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MRSA and VRE!!!!
Is anyone else having a large-scale outbreak of mrsa and vre in their area? How long ago did it become a major topic of safety in your area? What other precautions(if any) other than your ppe are you taking or think we should be taking?
On a personal note I dealt with an MRSA infection to my rt hand back in march, and I will tell you that this is something that you don't want to get, it hurts like hell and if untreated it can kill. Stay safe out there. Chris W. ERCVFD
On a personal note I dealt with an MRSA infection to my rt hand back in march, and I will tell you that this is something that you don't want to get, it hurts like hell and if untreated it can kill. Stay safe out there. Chris W. ERCVFD
Replies to This Discussion
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Permalink Reply by anne potter on
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statrted to find it in the schools wrestlers,basketball,and soo on .. None good hand washing and proper ppe when needed... now that they have ran out of anitibotics to treat alot of stuff be prepared for new diseases.....there is alot of new antibiotics out there but like all the other we will abuse those also..
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Permalink Reply by ERCVFD 842 C. Warren on
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Anne unfortunately, with the new strains of vre and mrsa that's being seen good hand washing and proper ppe may not be enough, I can attest to this personally I have always been a tightwad about ppe and proper handwashing and even using hand sanitizer after every pts contact even if it was just shaking hands, you must also consider the entire truck and all equipment(this includes the cab) considering that some of the new strains can survive for days on most surfaces. We have had a huge increase of cases in the nursing homes, I'd have to say 99% of all the nursing home pts I've hauled in the past year have had mrsa, vre, or both. When I contracted my infection, from the best I can figure, the day before I really knew anything was going on, I had worked with a part-time EMT and we had several nursing home calls with pts with mrsa and he was getting in the cab with his gloves still on, so it may not be enough for just ppe and handwashing. Stay safe out there. Chris W. ERCVFD
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I have worked in a hospital for 10 years.. your are right the infection rate is sky high. The problem is you need antibiotics to cure the problem and after a while more till it works no more.. Then new meds new diseases.. Our infection control officer on the floor DR. Duah states that probally if you think about we all have it.. I haver been a nurse for 10 years i probally have it also.... Sad when you get down to it..
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Permalink Reply by The God and Goddess on
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Hi Chris,
My husband has been dealing with MRSA and VRE for 10yrs. ever since he was injured on the job. Once you have these two types of infections, they stay w/ you. MRSA and VRE is "really" hard to get rid of. If you want more information about these two types of infections go to www.webmd.com.
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Permalink Reply by Justin Buck on
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what does it even look like
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weeks of antibiotics pic line .. at our hospital two checks to get a clear .. after 2 years they suggest a recheck
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Permalink Reply by Jeanine on
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I actually attended a lecture put on by a epidemeologist and what it all comes down to is hand washing and PPE. But with the ever mutating cells, even vanco is not an effective. He did make the point that the "over use" of penicillin in the past has brought us to this point when we must keep developing stronger antibiotics to fight these infections. Also with the reasearch being done is that people actually have MRSA and dont know it until they have an "outbreak" so to speak.
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Permalink Reply by Dave on
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We deal with this issue fairly regularly and unfortunately usually find out after we have engaged the patient. We always use universal precautions but it is still concerning being in that enviroment. One thing we due to prepare for these cases is to have our dispatch notes come up warning of this hazard when we have been to this residence before.
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MRSA infection is caused by Staphylococcus aureus bacteria — often called "staph." MRSA stands for methicillin-resistant Staphylococcus aureus. It's a strain of staph that's resistant to the broad-spectrum antibiotics commonly used to treat it. MRSA can be fatal.
Most MRSA infections occur in hospitals or other health care settings, such as nursing homes and dialysis centers. It's known as health care-associated MRSA, or HA-MRSA. Older adults and people with weakened immune systems are at most risk of HA-MRSA. More recently, another type of MRSA has occurred among otherwise healthy people in the wider community. This form, community-associated MRSA, or CA-MRSA, is responsible for serious skin and soft tissue infections and for a serious form of pneumonia.
Staph skin infections, including MRSA, generally start as small red bumps that resemble pimples, boils or spider bites. These can quickly turn into deep, painful abscesses that require surgical draining. Sometimes the bacteria remain confined to the skin. But they can also penetrate into the body, causing potentially life-threatening infections in bones, joints, surgical wounds, the bloodstream, heart valves and lungs.
MRSA is a strain of staph that's resistant to the broad-spectrum antibiotics commonly used to treat it.
Staph infections
Staph bacteria are normally found on the skin or in the nose of about one-third of the population. If you have staph on your skin or in your nose but aren't sick, you are said to be "colonized" but not infected. Healthy people can be colonized and have no ill effects. However, they can pass the germ to others.
Staph bacteria are generally harmless unless they enter the body through a cut or other wound, and even then they often cause only minor skin problems in healthy people. However, staph infections can cause serious illness. This most often happens in older adults and people who have weakened immune systems, usually in hospitals and long term care facilities. But in the past several years, serious infections have been occurring in otherwise healthy people in the community, for example athletes who share equipment or personal items.
Antibiotic resistance
Although the survival tactics of bacteria contribute to antibiotic resistance, humans bear most of the responsibility for the problem. Leading causes of antibiotic resistance include:
Unnecessary antibiotic use. Like other superbugs, MRSA is the result of decades of excessive and unnecessary antibiotic use. For years, antibiotics have been prescribed for colds, flu and other viral infections that don't respond to these drugs, as well as for simple bacterial infections that normally clear on their own.
Antibiotics in food and water. Prescription drugs aren't the only source of antibiotics. In the United States, antibiotics can be found in livestock. These antibiotics find their way into municipal water systems when the runoff from feedlots contaminates streams and groundwater.
Germ mutation. Even when antibiotics are used appropriately, they contribute to the rise of drug-resistant bacteria because they don't destroy every germ they target. Bacteria live on an evolutionary fast track, so germs that survive treatment with one antibiotic soon learn to resist others. And because bacteria mutate much more quickly than new drugs can be produced, some germs end up resistant to just about everything. That's why only a handful of drugs are now effective against most forms of staph.
Because hospital and community strains of MRSA generally occur in different settings, the risk factors for the two strains differ.
Risk factors for community-associated MRSA (CA-MRSA)
Young age. CA-MRSA can be particularly dangerous in children. Often entering the body through a cut or scrape, MRSA can quickly cause a widespread infection. Children may be susceptible because their immune systems aren't fully developed or they don't yet have antibodies to common germs. Children and young adults are also much more likely to develop dangerous forms of pneumonia, which can result from CA-MRSA, than older people are.
Participating in contact sports. CA-MRSA has affected sports teams. The bacteria spread easily through cuts and abrasions and skin-to-skin contact.
Sharing towels or athletic equipment. CA-MRSA has spread among athletes sharing razors, towels, uniforms or equipment.
Having a weakened immune system. People with weakened immune systems, such as those living with HIV/AIDS, are more likely to have severe CA-MRSA infections.
Living in crowded or unsanitary conditions. Outbreaks of CA-MRSA have occurred in military training camps and in American and European prisons.
Association with health care workers. People who are in close contact with health care workers are at increased risk of serious staph infections.
In addition to these risk factors, CA-MRSA is also spreading through certain groups of gay men. A study published in the Annals of Internal Medicine found a new strain of MRSA spreading rapidly among gay men in Boston and San Francisco. For example, gay men in San Francisco were 13 times more likely to be infected than others in the city.
Risk factors for health care-associated MRSA (HA-MRSA)
A current or recent hospitalization. MRSA remains a concern in hospitals, where it can attack those most vulnerable — older adults and people with weakened immune systems, burns, surgical wounds or serious underlying health problems. This is particularly true if you have a hospital stay of more than 14 days. A 2007 report from the Association for Professionals in Infection Control and Epidemiology estimated that 46 out of every 1,000 people hospitalized are infected or colonized with MRSA.
Living in a long term care facility. MRSA is also prevalent in these facilities. Carriers of MRSA have the ability to spread it, even if they're not sick themselves.
Invasive devices. People who are on dialysis, are catheterized, or have feeding tubes or other invasive devices are at higher risk.
Recent antibiotic use. Treatment with fluoroquinolones (ciprofloxacin, ofloxacin or levofloxacin) or cephalosporin antibiotics can increase the risk of HA-MRSA.
Keep an eye on minor skin problems — pimples, insect bites, cuts and scrapes — especially in children. If wounds become infected, see your doctor.
Signs and symptoms of a wound infection
Redness, warmth and tenderness of the wound
Pus — a yellowish-white fluid that may have a foul smell
Fever
Ask to have any skin infection tested for MRSA before starting antibiotic therapy. Some drugs that treat ordinary staph aren't effective against MRSA, and their use could lead to serious illness and more resistant bacteria
What is VRE?
VRE is Vancomycin-Resistant Enterococcus.
Enterococcus are bacteria that live in the digestive and genital tracts. They are normally benign and don't cause any problems in healthy people.
Vancomycin is a powerful antibiotic that is often the antibiotic of last resort. It is generally limited to use against bacteria that are already resistant to penicillin and other antibiotics.
Vancomycin-Resistant Enterococcus is a mutant strain of Enterococcus that originally developed in individuals who were exposed to the antibiotic. It was first identified in Europe in 1986, and in the U.S. in 1988.
Why is it dangerous?
It is not dangerous in healthy people with strong immune systems, where the balance of healthy flora in their digestive tract helps keep VRE from getting out of control.
VRE is dangerous because it cannot be controlled with antibiotics, and it causes life-threatening infections in people with compromised immune systems - the very young, the very old, and the very ill.
It is especially dangerous because it can easily transmit the resistance genes to other, more dangerous bacteria, such as staph and strep. Two cases of vancomycin-resistant staph have been identified in the U.S. in the last two months. These could cause serious infections even in otherwise healthy people.
How can it affect me?
Although VRE generally doesn't affect healthy people, anyone who comes in contact with the bacteria can become a carrier. Once you become a carrier, you can easily spread the bacteria to friends and family. In addition, if you become a chronic carrier of VRE, you could easily become infected when you are older or in declining health.
The spread of VRE isn't thoroughly documented or understood, but estimates from Europe are that 3.5% to 5% of the population may be carriers of VRE. VRE first appeared in the U.S. on the East Coast and spread to the West Coast. It is likely that carrier rates in those areas will take a couple of years to catch up to the European carrier rates.
It's particular important to avoid becoming a carrier if you share a home with those at risk - the very young, the very old or the very ill.
How can I be exposed to it?
You can be exposed to VRE by coming in contact with a contaminated object or person, or by eating contaminated food.
In Hospitals - The most likely place to pick up VRE is in hospitals, since this is where VRE tends to originate. In the U.S., all reported cases of VRE were acquired in a hospital. (This is according to the information currently publicly available - this information changes rapidly.)
VRE has been cultured from hospital equipment, doorknobs, and bedrails. It has also been cultured on the hands of hospital personnel. Anyone who frequents hospitals should be considered at risk for carrying VRE.
Of course, you can be exposed to VRE by a single visit to the hospital, but people who work in hospitals (even administrative personnel) are at much higher risk for being exposed and becoming a carrier.
How can I avoid it?
Fastidious hygiene is the best way to avoid ingesting VRE and becoming a carrier. VRE is a robust bacteria and has been found on hospital personnel's hands after five seconds of hand washing. It is recommended that you wash your hands for twenty seconds with an antibacterial soap every time before you eat. (Note that this means right before you eat. If you are eating in a restaurant and have been handling the menu, you could have picked up VRE. Wash your hands thoroughly before you pick up that piece of bread.)
Note that the most likely place to pick up VRE is probably the door handle of the rest room. Consider using the towel you dried your hands with as a protective shield when you open the door.
Avoid hospitals, as this is the only documented source of VRE in the U.S. If you do go to a hospital to visit someone, maintain fastidious hygiene throughout your visit. Avoid eating while at the hospital, and especially avoid eating hospital food.
In general, avoid taking antibiotics. You don't want to become a breeding ground for an antibiotic-resistant infection.
What if I need hospital treatment?
First, consider your options. Is it possible to receive treatment in the caregiver's office or in an outpatient surgery center?
If a hospital stay is absolutely necessary, it is probably wise to ask thorough questions about the hospital infection situation. Request written information about the hospital's record regarding VRE - how many infections have there been? When was the most recent infection? How many people were infected? How often are hospital personnel tested for VRE carrier status? How many staff are known to be VRE carriers?
It's best to request that this information be provided in written form, and dated and signed by your caregiver. This way your caregiver will know that you are serious about getting accurate information.
Consider asking all the hospitals in your area. You may be surprised at the variance of infection rates. In particular, university and teaching hospitals have much higher rates of infection than community hospitals, and it may be possible to arrange to stay at the hospital with the lower infection rate.
As a patient in a hospital, you have to decide how paranoid you want to be about the possibility of exposure to VRE. It's probably safest to avoid eating any raw vegetables from the hospital kitchen. Wash your hands thoroughly before eating, and avoid eating any foods with your hands.
It's certainly safest to have anyone who touches you put on sterile gloves first, but this is unlikely to be their standard procedure.
Request a copy of their guidelines for avoiding hospital-acquired infections, and remind hospital personnel to abide by those guidelines.
What if I've been in a hospital recently?
You might want to call the hospital and ask about the infection situation there prior to and during your stay.
If the hospital has a history of VRE, consider the possibility that you might have been exposed during your stay, and you might now be a carrier.
Those who are VRE carriers are unlikely to know it. It is possible to be cultured to find out if you are a VRE carrier, but this is unlikely to be covered by a health plan.
If you think there's a possibility that you were exposed to VRE and might be a carrier, you should maintain fastidious hygiene in order to avoid spreading the bacteria. It is important to wash your hands for twenty seconds with an antibacterial soap every time after using the toilet. This will reduce the chance that you will spread VRE to others with whom you come in contact. Be especially fastidious if you are regularly in contact with those at risk - the very young, the very old, or the very ill.
If you are certain that you were exposed to VRE or suspect that you may have become a carrier, it is essential to maintain your own good health in order to avoid developing a serious infection.
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Permalink Reply by Jason Koontz on
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we have a few nursing homes in the area that have mrsa outbreaks. One we call MRSA manor, just because any patient that goes in to the place gets it. For contact mrsa, usual precautions, total decon of the rig after, and vigorous handwashing before and after the call. For respiratory mrsa, the patient and the crew all get n-95 masks, full gowns, as well as normal glasses and gloves. The bed and rig get a total decon wipe down after this patient as well. We've had this up here pretty regularly about 6 years. The vre just hit last year, we treat them all the same as the respiratory mrsa patients. Bad juju to get, for sure!
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Permalink Reply by Oldman on
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Ladies and gentleman, MRSA is becoming a concern in Fire/EMS stations as well. Not necessarily in the areas you might think it would be.
http://firechief.com/health-safety/ar/firefighting_lurking_danger_0...
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