to worry that this kid's MRSA might be a risk for my DD?

[Jean4genes]

A friend of mine brings her daughter round at least weekly, and she's had severe nappy rash for at least two months. She's been doing lots of nappy changes here. She finally had a swab taken last week, and it shows she has MRSA there - she told me this during her last visit. I asked if she was sure it was ok to bring her round here, as my daughter has a gastrostomy (a feeding tube directly into her stomach) as well as being extremely prone to ear infections. She said the doctor said it would be ok.

But I'm still concerned! Friend changed her nappy later and I had to remind her to wash her hands, as she went to sit down again, so I am now worried about the risk to my daughter. She has an ear infection right now, which hasn't cleared up after antibiotics - it's not the first time, so I know it could be just a different bacteria, but it does put me on edge about the whole thing! I'm taking DD back to the doc's tomorrow and will ask for a swab (she's had swabs loads of times, no MRSA) but even if it shows no sign of MRSA, I worry about continued risk if they keep visiting.

I don't want us to fall out, but I have to think about my kids first!

So, any advice anyone? thanks!

Phone NHS direct and ask them for advice

I would certainly be erring on the side of caution if your DD is susceptible to infection, perhaps just say to your friend that you're too busy to meet until you know that an appropriate period has passed for it to be safe?

This worry comes at a particulary difficult time though - it's supposed to be her birthday party this Saturday, and she will be so upset if her friend doesn't come! I certainly don't want to make them feel like lepers if you know what I mean, but I do worry about how careful her mum is about hand washing!

When DD was about 10 months old we spent a few days in hospital where a kid had MRSA, was in a side ward and the mum always used gloves when tending to her, as well as good hand washing. So should she be doing the same, I wonder...

You are right to be worried.

However hopefully she will have have been given something for it.

Good idea to request screening your DD. In the meantime buy some alcohol gel and get her to use it when she comes round, and use it yourself too prior to touching the gastrostomy tube.

Good luck x

Do you really think, if the child had a highly contagious strin of MRSA (which every one has anyway) tha she wouldnt be in quarantine in hospital? Do you really think she would be allowed out amongst the general public?

Yes people with MRSA are in the community.

Keeping someone in hospital with MRSA that isn't systemically infected (ie blood poisoning with it) is madness as there is a risk it will be transferred to pts who are more vulnerable.

Everyone has staph aureas, but not everyone has the meth resistant strain.

For your peace of mind, I'd go for the usual hygiene precautions and perhaps not let the children get too cuddly. I wouldn't worry too much though, 25% of the population are colonised by MRSA anyway.

troisgarcons, My concern is not so much that she has MRSA, but in the risk of my daughter catching it due to the mum perhaps not being as careful with hygiene as she perhaps should be. And perhaps it's assumed that the MRSA is not risky to others because it's in an area that isn't so likely to be in close contact with the general public (being in her "nappy area"). Thing is that I've seen her mum clean her bum and go to sit down without washing her hands - that's a no-no even without an infection!
And surely, a bacteria infecting the skin around the "nappy area" might be milder then the same bacteria getting into a gastrostomy, which is an unnatural opening of the skin, all the way into the body?

Er, are you sure everyone has MRSA?

fishfingersandcustard, one problem is both my DD and the girl have special needs and are extremely affectionate! So it would be hard to keep them from being too cuddly, and the girl cuddles my Ds even more, and he's only 7, and of course he cuddles his sister lots! This would happen now, with DD's party in a few days - sods law!

I think you are right to be a bit wary of MRSA if your dd has a gastrostomy - MRSA around the exit site might cause an uncomfortable local infection.
Y would NBU to insist on handwashing after nappy-changing, and to make sure (as you probably do already) that hands are properly cleaned by anyone handling the gastrostomy tube/dressing.

I have also heard that MRSA is very, very common - (not sure if everyone has it but I have heard similar) - however, most people with MRSA are not ill with it so do not know they have it.

Normal hygiene measures should be safe enough but, at the end of the day, if you are worried for your DD's safety (especially if she has health issues which make her more vulnerable) then I would suggest meeting your friend elsewhere for the time being.

It really depends on if the baby?s skin is colonised with MRSA or is actively infected. If it's infected she/he should be on Anti-biotics for MRSA, and once they've been on them for 24-48 hours no issue.

And to be honest I would be very very surprised if your daughter hasn?t been colonised at some point (or you) if you?ve been in and out of hospital.

Colonization just means that you are well but are a carrier of the bacteria. It?s usually found in the groin area, under the arms but especially in the nose.

The thing that all the scare papers don?t tell you is that MRSA is actually easier to treat in the community that in hospital. The reason that they are put in side rooms etc. in hospital is usually because they don?t have enough rooms for patients with wounds etc.

The best thing you can do is to (a) carry on reminding Mum to wash hands after nappy changes; which she should be doing anyway. And (b) keep DD's gastrostomy site covered when they?re around; i.e.: with clothes as normal.

As for the ear infection it is possible though unlikely, if you are taking her to the doc I would inform her/him about it, but I wouldn?t make a special trip.

The thing you have to remember is that a big proportion of the population is colonized and will never know, so she will have been in contact before, the difference is here that you actually know about it and can take sensible measures.

And the risks from hugging are minimal but if you are that worried about the gastrostomy site why not cover it with some gauze etc when they are visiting? But don?t let the site get ?sweaty? or you will get skin break down and give yourself a whole new set of problems.

I have assumed that you wash your hands before touching gastro site. . I know I shouldn't assume , but it common sense and it sounds like you have a fair amount of that

I picked up MRSA when in hospital (only found out because I had two operations and tested positive before the second one 3 weeks after the first, for which I had tested negative). I was assured that I couldn't have caught it in hospital and must have picked it up in the community as something like 30% of the population are carriers. .
In order to get rid of it we had to follow a very very onerous programme of washing - all bedding, towels, face cloths etc to be washed at 90% EVERY DAY for 5 days. Everyone in the house to shower twice a day, using hibiscrub to wash, including hair, then test again.
I was not allowed to enter hospital for the second op until I had a negative test. And I was asked to work from home by my boss.

I was fully prepared to say YABU lots of people have it in the community etc but TBH I would be concerned about your daughters PEG it is a potential site for infection. MRSA is pretty easily treated if not in a wound so get her swabbed.

youtalk MRSA is not easily treated. See my post above.

Oh and I forgot to mention shoving cream up your nose for a fortnight.

Call me unreasonable if you like, but they would be banned from my house! ;)

Sorry I consider changing shampoo/bodywash to hibiscrub and using powder in groin etc easily treated it's not that difficult.

Do you consider washing all bedding and towels on 90 deg every day for almost a week in the middle of winter "easily treated"? I could manage it, but what if you have small children or are elderly? It's not "difficult", but it's incredibly onerous.
The hospital did tell me that the reason why it is endemic in nursing homes is because the hygiene aspect is so very challenging.

Well, We saw the GP today, who took a swab, but was very rushed and made it rather difficult to ask questions! He did say though, that if we're lucky, the swab results may be available on Friday.

To avoid any confusion, the little girl who regularly visits is actually suffering from MRSA infection. Not simply colonised with the bacteria. I would expect, in the circumstances though, that her mum is colonised and possibly myself and my two kids. I suspect that she may have had this for some time, she has had nappy rash like I have never seen before for at least two months!

Jingle, I would have thought people ill with MRSA would know it, people who carry it would not know.
If you are ill with MRSA you can become very sick indeed and have to be hospitalised if the oral antibiotics don't work.

@ Jean, as your friend's child has had the nappy rash for such a long time, ask her to investigate manuka honey and how it could be applied to the nappy rash. Some papers have shown it to be effective for MRSA infection.

Also tell your friend that she ought to improve her hygiene routine! She should be concerned about passing it on to your family. Until she does take better care, she should really stay away.

phone your own GP or consultant and ask him/her.