MRSA

[packrat]

Can anyone talk to me about this? We have a new student coming who has it, and also a feeding tube. The lead teacher was told it's localized to the feeding tube area, student wears a belt to cover it, whoever does the feedings needs to wear gloves and wash before/after. That's it.

I'm kind of irritated that all of the staff was not talked to about this, just the lead teacher, and she was given a paper to read to us "this is what we need to do", which is what I wrote in my opening two sentences, and when we asked questions, she had no answers for us, so we're just left wondering what to do. There is a nurse that has 30 minutes per month to come to the classroom and check w/us, answer questions, see how things are going.

The student starts the day we return from break, and we were just given the "heads up" today, the day we get out early for break.

How concerned do we need to be? Not just for ourselves, but we have 18 other kids in the room too, and they're all between two and a half and four years old. Nobody has figured out about covering noses/mouths, not picking noses and wiping it willy nilly, not putting toys in their mouths etc.

We've already got a student w/a feeding tube; I can do those feedings, insert and remove the tube etc w/my eyes closed, so we're not worried about that part. The infection is what we're concerned about.

 

[JDDN]

Hi Packrat,

Is it a chronic infection or is it an acute infection that is currently being treated? If it's well covered and the person doing the feedings is very careful with gloves and thorough hygiene it shouldn't be a problem for the other kids. Unless the other children have direct contact with the area that's infected (or the gloves that were used and discarded) they should be safe. I'd make sure whoever is doing the feedings is tossing the gloves in a very secure sealed garbage where there is no chance of contact with them.

 

[packrat]

No clue. That's one of the questions I asked and I got a shrug and "That I don't know. It's just says MRSA, wear gloves". The only thing I know is the student takes a couple antacid meds at home, there was no other mention of medications. I'm *guessing* chronic, b/c it sounded like the student has been wearing the belt (no clue what that means either-belt like belt for pants, or belt like a belt of gauze around the midsection to hold the bandage over the area? again, no explanations of anything) for a while.

We're given no thoughts on what to do for location of feedings either. Our student currently, we lay down, clamp it shut, remove, unclamp, flush, clamp, (remove the tube sometimes) done. Students up and gone, and we do it in the room. Do we need to take this new child to a separate area? Do we need to shoo the other kids away every single time? B/c kids that age you need 42 arms to keep them out of stuff when you're busy. If we need another staff member to help, if the child is wiggly, does that person need to wear gloves just to keep the child's hands occupied? The bags are done at not always the most opportune times. Do we need to all have gloves on us at all times? Carry a red bag w/us? We've taken care of the other student while outside, in the lunchroom, in the hallway etc. The current student's tube has come unhooked a few times-and we don't always see it right away, especially if we're sitting down at the table. Then what? Is that a concern that we need to get other kids out of the area and disinfect and glove up etc? Are Clorox wipes enough?

"wear gloves, wash before and after" is our only instruction.

We just kind of stared at each other like.."so..ooookay...um.."

My husband's mother has it, has had it for a few years, and in order to go into her room staff gowns up, puts on hair covers, face masks, gloves, foot covers etc.

Does that mean there are different levels, that MRSA is a Schrodinger disease? It's serious but not?

 

[wildcat03]

MRSA is very common. You can be "colonized" with MRSA - carry it on your skin and in your nose without showing signs of infection - or infected (pneumonia, urine infection, infected skin ulcer, abscess). In this day and age, being colonized with MRSA not particularly uncommon. The most common MRSA infections we see are skin infections (usually abscesses). They are common in all ages. Generally they are NOT caused by contact with another person who has MRSA, but often seem to result from skin breakdown (shaving is a very common culprit) or friction of skin in wet/sweaty spaces (armpits, skin folds).

As far as the student, it doesn't sound like there's a whole lot to worry about. Hand washing before and after, gloves whenever touching the g-tube or area around it. If there's drainage from the skin around it, then probably a call to the nurse or a discussion with the child's caregiver.

ETA: Where I work we do not have to wear shoe covers or caps for MRSA. Just gowns and gloves. It's mostly for the protection of the patient's room we go in NEXT - not ours. (And there's no evidence that it does anything...). I have touched a patient with MRSA without gloves before in an emergency. I just wash my hands immediately after - as I would if I touched any patient without gloves. No need to carry a red bag with you, but a pair of gloves tucked in your pocket would be good (and honestly I would use gloves whenever I touched a feeding tube - MRSA or no).

 

[azstonie]

MRSA is incurable. It is beaten back periodically with antibiotics while it colonizes you. It can prevent a person from being treated with the existing regimens for, say, cancers treated with chemotherapy, or valley fever.

I don't know what they are paying you but it most likely is not enough to balance the risk to you. It is very difficult to 'kill' MRSA and I doubt enough contact time with whatever sterile regimen could be achieved in a school setting, particularly with very young students.

The New York Times archives and New Yorker Magazine archives have excellent material on MRSA.

 

[VRBeauty]

One of my brothers contracted MRSA while hospitalized. After that, in any hospital setting, we had to suit up (gown and gloves) while visiting him. Not so once he was home, however - gloves were used only when doing things you'd normally use gloves for anyway (dealing with his J-tube, for example). The MRSA was of course noted when he went into hospice (about a year later), but I don't recall the hospice nurses suiting up and we were not provided gowns for the family, just gloves to use when providing direct medical care. Of course we did was our hands a lot and use lots of sanitizing gel, and my SIL was well versed in disposal protocols etc. There were quite a few of us in contact with my brother during the two months he was in hospice, and no one contracted MRSA.

If you're in a situation where there are little kids around however - I think you'd want some procedures in place and maybe an area set aside for providing care to the MRSA student. Wouldn't the school want to show that they have a protocol in place etc. etc. etc. to protect the staff and students... and to protect the school from a liability standpoint?

 

[MJ_Mac]

My father-in-law had MRSA when he was in a care home. He also had a feeding tube. He had a big isolation sign on his door although that didn't mean we couldn't visit. We just had to check in with nursing staff first. I have an immune system disorder that I've had for 30 years (chronic neutropenia) so I asked my doctor about what I should do. I had to be masked, gowned and gloved when I went to see him. I couldn't even give him a kiss on the cheek which was very difficult. My husband, who has a normal immune system, just had to make sure he washed frequently. And yes, there was lots of hand sanitizer. My doctor said as an extra precaution we should wash our clothes immediately afterwards.

So I would say there isn't a huge risk unless someone who is in contact has a compromised immune system. I find it odd they would have this young girl in a school environment with lots of children but I don't know what age children start building resistance and their immune system gets stronger. The age group you mentioned seems awfully young to be exposed to something like this. I would hope a letter went out to all parents letting them know of the situation. I too would be concerned as you mentioned children that young haven't learned the basic concept of washing hands after sneezing or blowing their nose and will likely put some of those shared toys into their mouths.

 

[momhappy]

MRSA is incurable. It is beaten back periodically with antibiotics while it colonizes you. It can prevent a person from being treated with the existing regimens for, say, cancers treated with chemotherapy, or valley fever.

I don't know what they are paying you but it most likely is not enough to balance the risk to you. It is very difficult to 'kill' MRSA and I doubt enough contact time with whatever sterile regimen could be achieved in a school setting, particularly with very young students.

The New York Times archives and New Yorker Magazine archives have excellent material on MRSA.

I agree with this.
Over the past several years, treatment of some staph infections has become increasingly difficult because the bacteria have become resistant to various antibiotics. As others have mentioned, MRSA is a type of staph that is resistant to some antibiotics. Infections caused by MRSA have historically been associated with ill persons in health-care institutions. However, MRSA has now emerged as a common cause of skin and soft tissue infections that may occur in previously healthy adults and children. MRSA can be transmitted from person to person through close contact. Risk factors includes direct skin-to-skin contact with the infected person, sharing contaminated personal items (e.g., towels, razors, soap, clothing), inadequate personal hygiene, direct contact with contaminated environmental surfaces, and living in crowded settings (I would think a classroom might be considered a crowded setting...).
I have a family member that has had a MRSA infection for about the past 10 years. It is incurable and has at times, been life threatening and it may eventually lead to the loss of that limb (or death). It has been horribly physically and emotionally painful.
I would say that I'm surprised that it is allowed within a school system, but we had the same thing happen in my child's preschool class. It was a very small school and none of the parents were even informed that a child had a MRSA infection. I would have thought that this would have been one of those better-safe-than-sorry things, but sadly, it wasn't.

 

[Tacori E-ring]

Most people that work in healthcare would test positive for MRSA in a nose swab. I believe It is just spread through contact so if no one touches it, it should be fine.

 

[Snowdrop13]

There is a difference between being a carrier of MRSA and being infected by it. If you are a carrier, you will have MRSA as part of the usual colonising bacteria on your skin- this sounds the case with your pupil. About 2% of people are carriers and it will be commoner in people who have spent time in hospital. If you become infected with the bacteria and it gets into the bloodstream then the infection is harder to treat as it has become resistant to some antibiotics. But not ALL antibiotics, there are still some left which can be used.

I think you need advice from the infection control department in your local hospital, I'd imagine strict hand washing would be a basic precaution plus some other protocols to prevent cross contamination.

 

[House Cat]

My husband has ingrown hairs on his thighs. His doctor said it was MRSA, gave him an ointment to put in his nose, told him to wash with hibiclense, and sent him in his way.

I think it is more common than we think. Look up "MRSA on face" and look at the images. You will see people with severe acne, but nothing that you haven't seen before.

When my husband was diagnosed, I read all about MRSA on the Internet and found that a lot of people had it. I bought hospital grade antibacterial wipes, made sure that everyone stayed clean, had everyone bathe with hibiclense. Oh, and we also did bleach baths. You might want to do these things to make sure you don't contract MRSA. At the very least, make sure your hand soap and wipes are able to kill MRSA (staphylococcus aureus) not all of them do.

 

[packrat]

I just googled MRSA on face-I have enough shit going on w/my face, I don't need that. Good gawd.

What I don't understand is, it's bad but it's not. It shuts hospitals down but it's no big deal. You can get it and be fine, or get it and die. Basically just cross your fingers that it doesn't get in your blood stream? I don't know that I want to take that chance, and I really don't think it's right that parents aren't being told. I don't think it's right that we're not given any sort of direction, so that I have to get onto an internet forum to get some sort of answers and find some sort of level of comfortable-ness w/this. If I had MRSA, would I not be required to let my employer know? You can get HIV and still be fine. That doesn't mean it's not a big deal.

We have no protocol in place for anything. None for any of the things I mentioned earlier-I have no clue what we're supposed to do. What if we were to decide if his tube comes unclamped, eh it's just MRSA, go wash your hands, and one of the kids contracted it? Anyone who has dealt w/a small child knows there are times that things happen-and then you make it 18 small children aged 2.5-4, and it's insane. If we have to send a note home b/c a child came to school for 5 minutes w/lice, even if they had absolutely no contact w/any other child and walked right out the door--I think parents should be aware.

And we've not specifically been told anything about the student's infection, so I can't say for sure that it IS localized. I don't like being in the dark about things. And if there's things that I need to do, if I need to start taking showers again at night and washing my clothes every single day-that's a lot to ask for $10/hour, 36 weeks a year. The school will not purchase special cleaners for us. We have Clorox wipes. Or we have to buy it ourselves. Again, a lot to ask for what we make, considering we go thru a container of Clorox wipes every couple days, wiping down everything we can daily b/c of the kids "eating" everything.

 

[monarch64]

I don't know, Packie. My SIL is in health care and she acts like it's NBD. I don't go to doctors/hospitals unless it's necessary or preventative maintenance, and when I have visited my dad the past few years I've worn a mask and gloves and I go by myself so I don't expose my husband or child to possible super bugs. (Also so we don't expose him to any weird germs.) Hopefully your school is equipped with the tools to keep everyone else from contracting MRSA, I'm not sure what else to say.

This is an amazing TED about the post-antibiotic world. Very interesting, very scary, but knowledge is power.

https://www.ted.com/talks/maryn_mckenna_what_do_we_do_when_antibiotics_don_t_work_any_more?language=en

 

[Snowdrop13]

http://www.liverpoolcommunityhealth.nhs.uk/downloads/a-z-services/posters-publications/MRSA_leaflet.pdf

I had a quick look through this leaflet, looks like it explains it all quite clearly, hope it helps a bit!

 

[Karl_K]

What I don't understand is, it's bad but it's not. It shuts hospitals down but it's no big deal. You can get it and be fine, or get it and die.

thats because saying MRSA is like saying its a brown beetle.
not going into it, today would have been my mom's birthday and she died of a resistant infection.
I would quit unless full training is provided.

 

[momhappy]

I just googled MRSA on face-I have enough shit going on w/my face, I don't need that. Good gawd.

What I don't understand is, it's bad but it's not. It shuts hospitals down but it's no big deal. You can get it and be fine, or get it and die. Basically just cross your fingers that it doesn't get in your blood stream? I don't know that I want to take that chance, and I really don't think it's right that parents aren't being told. I don't think it's right that we're not given any sort of direction, so that I have to get onto an internet forum to get some sort of answers and find some sort of level of comfortable-ness w/this. If I had MRSA, would I not be required to let my employer know? You can get HIV and still be fine. That doesn't mean it's not a big deal.

We have no protocol in place for anything. None for any of the things I mentioned earlier-I have no clue what we're supposed to do. What if we were to decide if his tube comes unclamped, eh it's just MRSA, go wash your hands, and one of the kids contracted it? Anyone who has dealt w/a small child knows there are times that things happen-and then you make it 18 small children aged 2.5-4, and it's insane. If we have to send a note home b/c a child came to school for 5 minutes w/lice, even if they had absolutely no contact w/any other child and walked right out the door--I think parents should be aware.

And we've not specifically been told anything about the student's infection, so I can't say for sure that it IS localized. I don't like being in the dark about things. And if there's things that I need to do, if I need to start taking showers again at night and washing my clothes every single day-that's a lot to ask for $10/hour, 36 weeks a year. The school will not purchase special cleaners for us. We have Clorox wipes. Or we have to buy it ourselves. Again, a lot to ask for what we make, considering we go thru a container of Clorox wipes every couple days, wiping down everything we can daily b/c of the kids "eating" everything.

I completely understand your frustration and concerns and I think that you are right to treat it with the seriousness that it deserves given the fact that it's in a school setting. Regular Clorox wipes likely won't kill it - you'd need Clorox Commercial Solutions Germicidal Wipes (or similar products). Some people in the healthcare industry have a different take on it and that's fine, but it should be treated as a case-by-case basis and even though it may be a common infection, doesn't mean that it's probably no big deal. I think that it's sad that you've been given very little info on it and it's unfortunate that the other parents are not made aware either. I was furious when I found out through the grapevine about the child with MRSA in my child's preschool and it created an atmosphere of anxiety and mistrust, which could have been avoided had we simply been informed and/or educated about the infection beforehand. I think that just because it may be a common (and sometimes fairly harmless) infection, that doesn't mean that it couldn't pose a risk in a school setting where young children are involved.

 

[canuk-gal]

HI:

Schools are big communities like hospitals, and therefore your school board would have a protocol on how to handle MRSA (and/or any other super bug). I would call your board or county or which ever legislative body is in your area and ask how to proceed. Perhaps your Principal or Vice can help--as they might have handled this issue before or have worked in another facility that used the same protocols.

cheers--Sharon

 

[purplesparklies]

My younger son had MRSA when he was around a year old. Pediatrician prescribed antibiotics. It would seem to go away but would flare up months later. This went on for a few cycles before I took him to Riley Children's Hospital. Specialist there decided to admit him for a surgical procedure to clean out the infected area. It still returned. I was terrified and heartbroken for my little guy who I thought was doomed to a lifetime of bleach baths and never getting to swim in a pool with the other kids.

A friend had a husband who had contracted MRSA while in the hospital for surgery. He went to a local crotchety old Dr. who had cured it. I contacted that Dr. who initially refused to see my son because he didn't work with children but I was desperate and pleaded. He relented and I made an appointment. When we saw him, I told him the whole story and how we had been fighting this recurrent infection for months and months and had even taken my son to a leading children's hospital. He grumbled about the course of treatment that had been recommended and attempted. Said they hadn't been doing that (including bleach baths) since the "dark ages". Prescribed a soap and a medicine, I think (it's been 9 years now), and told me he would not need to see me again. I broke down and cried and hugged him. Infection went away and never flared up again.

During the time of infection, the doctors never recommended excessive care with day to day routine. Only caution was really in regards to pools and bathtubs. We could not let our boys bathe together and we couldn't let my younger son go in the pool. Perhaps there are different degrees of seriousness of MRSA?

 

[wildcat03]

I just googled MRSA on face-I have enough shit going on w/my face, I don't need that. Good gawd.

What I don't understand is, it's bad but it's not. It shuts hospitals down but it's no big deal. You can get it and be fine, or get it and die. Basically just cross your fingers that it doesn't get in your blood stream? I don't know that I want to take that chance, and I really don't think it's right that parents aren't being told. I don't think it's right that we're not given any sort of direction, so that I have to get onto an internet forum to get some sort of answers and find some sort of level of comfortable-ness w/this. If I had MRSA, would I not be required to let my employer know? You can get HIV and still be fine. That doesn't mean it's not a big deal.

We have no protocol in place for anything. None for any of the things I mentioned earlier-I have no clue what we're supposed to do. What if we were to decide if his tube comes unclamped, eh it's just MRSA, go wash your hands, and one of the kids contracted it? Anyone who has dealt w/a small child knows there are times that things happen-and then you make it 18 small children aged 2.5-4, and it's insane. If we have to send a note home b/c a child came to school for 5 minutes w/lice, even if they had absolutely no contact w/any other child and walked right out the door--I think parents should be aware.

And we've not specifically been told anything about the student's infection, so I can't say for sure that it IS localized. I don't like being in the dark about things. And if there's things that I need to do, if I need to start taking showers again at night and washing my clothes every single day-that's a lot to ask for $10/hour, 36 weeks a year. The school will not purchase special cleaners for us. We have Clorox wipes. Or we have to buy it ourselves. Again, a lot to ask for what we make, considering we go thru a container of Clorox wipes every couple days, wiping down everything we can daily b/c of the kids "eating" everything.

If someone had a MRSA infection or MRSA postive swab, I don't think they would be obligated to inform their employer.

Also, because MRSA is part of the child's health history, I'm not sure the parents CAN legally be informed but I could be wrong on that.