-----Original Message-----
From: Dr L Russell <[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Date: 08 June 1998 18:22
Subject: RE: MRSA on nappy rash
This is the first community MRSA I have ever come across up here,
>and it bodes ill, although I doubt it will do the kid any harm.
>
>Has anyone else seen cases like this? I guess it must be more common down
>south.
>
We are inundated here. Many patients are being discharged into the community
with MRSA. There is no significant attempt to control further spread.
Barrier nursing is no longer even attempted at the DGH because of shortage
of nursing staff. Home care, and community nursing staff deal with MRSA and
then
proceed on to their next cases regardless.Leg ulcers seem to be a common
source. We often have medical patients with it in the community hospitals,
usually transferred back form the DGH I hasten to add. Management, in it's
usual penny pinching wisdom, is now issuing hospital nurses with only one
set of uniform. Community nurses are often seen in "mufty". What chance
routine basic infection control measures! At our community hospital we've
just completed giving daily iv infusion of vancomycin to one hapless patient
who went in to the major unit for routine knee arthroscopy and nearly lost
his leg. Damned difficult stuff to give - its only just soluble and when
mixed with the diluent you have to roll the bottle gently for around
10minutes to get it into solution without frothing. Then the drip needs
changing every few days. That's the sort of underpaid extended role we get
as GPs working in community hospitals! At least our community hospital
theatres are clean at present - more than can be said of the major units.
The HA is
now trying to close the community hospital theatre to save money. We are
argueing that the county will need alternative "clean" sites for
surgery as theatres will inevitably become infected and need closure for
sterilisation. All your eggs in one basket etc!
Did I read that a phage virus for MRSA has been developed from sewage in the
USA? Biological control might well be the answer.
Peter Fellows
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