Staph question

[cfiddlinmama]

Hello Wise Women, I have a question for you. I'm supposed to be apprenticing with the CPM who attended two of my births. Two months ago, I had a boil type sore on my shoulder. I was able to clear it up with sea salt and tea tree oil. I have had no re-occurrences since. None of my family has had any boils or anything. My extended family heard about it and there was a lot of fear fueled staph gossip going on. I felt I needed to let my preceptor-to-be know about it. She would like me to get a nasal culture to make sure that I don't have MRSA. I never had the boil tested so I don't know what caused it. She said that she wouldn't necessarily expect me to go on abx if it came back positive. We could do herbal/natural treatments to get rid of it. She's just worried about the risk of spreading MRSA to moms and babies.

In a way it seems silly to me since staph is all around us. The moms aren't exactly going to be testing everyone they come into contact with. It seems like if I don't have any active lesions it shouldn't be a concern.

I was just wondering what you would expect from an apprentice in a situation like this. Have you ever had yourself tested or an assistant/apprentice?

Thanks for any advice. I greatly appreciate it.

[MsBlack]

Hmmm, seems a bit excessive to me, too. Yes, staph is everywhere....and without active sores I would not be worrying.

[holly6737]

It's my understanding that you're only contagious if you have an active sore and that many of us harbor staph in our noses without realizing it. Harboring staph isn't the same as being infected with staph- at least that's my understanding. If that's true, abx wouldn't help anyway. (I only know this b/c we are actually fighting a MRSA infection right now with my son and no one else in the family has become infected.)

[1stimestar]

After seeing what my aunt has gone through and is still going through with MRSA, I would want anyone at my birth who has had any type of boil to get tested before coming into my home. It may seem to be an irrational fear but wouldn't you want to know for sure?

[cfiddlinmama]

Thank you for your replies. I want to reiterate that there is no active infection going on at all.

Does anyone (Dr Jen, anyone?) know what type of culture is taken to test for MRSA? Is it something the mw could do for me? She does lab work (blood draws, paps, STD screenings, etc.). Is it just a nasal swab or is there something more invasive that needs to happen?

I talked to several doctors' offices and occupational medicine at our local hospital. The drs had never even heard of such a test being done and had no idea how to go about getting one. Occupational medicine was no help.

I have an acquaintance who is a family practice doc and might be willing to do me the favor. I don't have insurance or a primary care doc. I would like to avoid going and getting a new patient exam/consult and paying the fees, plus the culture and probably a re-culture, after treatment, if it came back positive.

Again, I'm thinking this is overkill but the mw is being cautious and I can respect that. It just makes me wonder how many drs and health care workers are walking around colonized and don't even know it. Having never even heard of having a nasal culture done. :


Holly6737 - did you get everyone in your family tested? How did they test your son? I'm sorry going through this...

[maxmama]

It's a nasal swab. No big deal -- big q-tip, into transport medium, see what grows.

With the increase in community-acquired MRSA, our hospital is starting to do nasal cultures on women planning to deliver with us with a history of MRSA infection, and use contact precautions on those who come up positive.

MRSA isn't a huge deal, in that it's not usually dangerous, except that newborns don't localize infection well and penicillins are usually one of the first-line abx used for newborn sepsis. IF babies are known to be exposed (potentially) to MRSA, then the initial antibiotic tx would be a non-cillin (my guess would be clindamycin and gent).

[cfiddlinmama]

Thanks maxmama! That's what I figured it would be. We're waiting for a call back from an infectious disease specialist. It sure would be easiest if my preceptor could do it herself....