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#1 Posted : 06 February 2007 21:25:00(UTC)
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Posted By David Kennedy
Today one of the cleaners in the nursing home that I advise expressed concern that she was in the early stages of pregnancy and could pick up MRSA which could give rise to a difficult-to-treat infection should she suffer tissue damage during her delivery. While this young lady does not have direct contact with any resident who is known to carry MRSA, she does cleaning work in their rooms and must therefore be at some level of risk of infection with MRSA as a consequence. It occurs to me this may be a common situation in the NHS and I should be grateful for views on best practice regarding the management of occupational MRSA risk in pregnancy.
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#2 Posted : 07 February 2007 08:44:00(UTC)
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Posted By Chris Packham
David

I am not sure if this will answer your question, but I hope will be of some help. These are the facts as my research into this has indicated.

It is known that a substantial proportion of the general public are carriers of MRSA. They are asymptomatic, i.e. don't know that they have it, nor is it presenting them with any problem, unless tested. It is even possible that your lady is a carrier, without being aware of this.

This is why one of the key factors in reducing hospital acquired infections is screening. A fried of ours recently had a hip replacement operation delayed as she was found to be an MRSA carrier on screening when going into hospital and it was only when this had been successfully treated that she had the operation.

The risk of your lady becoming infected by MRSA in her workplace is probably little higher than out in the real world. Provided she maintains a good standard of personal hygiene, in particular hand hygiene (regular washing with a mild liquid soap - not an antimicrobial one - if appropriate an alcohol sanitising rub and a skin conditioning lotion. Use of appropriate gloves if there is potential contact with body fluids etc) then the risk of infection is relatively small.

Even if she is a carrier of MRSA, this does not mean that she would necessarily suffer an infection unless the bacteria could gain access to the damaged tissue.

If you would like to know more please feel free to contact me direct.

Chris
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#3 Posted : 07 February 2007 11:16:00(UTC)
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Posted By Diane Thomason
David
Good info from Chris.
Would advise that the lady asks her doctor or midwife for advice on this - they will advise on any OH aspect related to pregnancy.
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#4 Posted : 08 February 2007 19:55:00(UTC)
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Posted By David Kennedy
Thanks for the responses so far. I should like to take up Chris Packham's offer for further information and should be grateful if he would let me know how I can get in touch with him.

David Kennedy
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#5 Posted : 08 February 2007 21:10:00(UTC)
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Posted By Adrian Watson
CCDC state that:

Healthy people are at low risk of getting infected with MRSA.

MRSA and VSA are the most commonly encountered multidrug-resistant organisms in patients residing in non-hospital health-care facilities, such as nursing homes and other long-term care facilities.

Non-hospital health-care facilities can safely care for and manage these patients by following appropriate infection control practices.

In general, healthy people are at low risk of getting infected with MRSA or VRE. Therefore, casual contact - such as kissing, hugging, and touching - is acceptable.

Staff and visitors should wash their hands before leaving an infected person's room.

Disposable gloves should be worn if contact with body fluids is expected.

Outside of health-care settings, there is little risk of transmitting organisms to persons at risk of disease from MRSA / VRE, therefore, healthy people are at low risk of getting infected.

In the home, the following precautions should be followed:

Caregivers should wash their hands with soap and water after physical contact with the infected or colonized person and before leaving the home.

Towels used for drying hands after contact should be used only once.

Disposable gloves should be worn if contact with body fluids is expected and hands should be washed after removing the gloves.

Linens should be changed and washed if they are soiled and on a routine basis.

The patient's environment should be cleaned routinely and when soiled with body fluids.

Notify doctors and other health-care personnel who provide care for the patient that the patient is colonized/infected with a multidrug-resistant organism.

Regards Adrian Watson
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#6 Posted : 08 February 2007 21:16:00(UTC)
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Posted By Adrian Watson
David,

CCDC state that:

Healthy people are at low risk of getting infected with MRSA.

MRSA and VSA are the most commonly encountered multidrug-resistant organisms in patients residing in non-hospital health-care facilities, such as nursing homes and other long-term care facilities.

Non-hospital health-care facilities can safely care for and manage these patients by following appropriate infection control practices.

In general, healthy people are at low risk of getting infected with MRSA or VRE. Therefore, casual contact - such as kissing, hugging, and touching - is acceptable.

Staff and visitors should wash their hands before leaving an infected person's room.

Disposable gloves should be worn if contact with body fluids is expected.

Outside of health-care settings, there is little risk of transmitting organisms to persons at risk of disease from MRSA / VRE, therefore, healthy people are at low risk of getting infected.

In the home, the following precautions should be followed:

Caregivers should wash their hands with soap and water after physical contact with the infected or colonized person and before leaving the home.

Towels used for drying hands after contact should be used only once.

Disposable gloves should be worn if contact with body fluids is expected and hands should be washed after removing the gloves.

Linens should be changed and washed if they are soiled and on a routine basis.

The patient's environment should be cleaned routinely and when soiled with body fluids.

Notify doctors and other health-care personnel who provide care for the patient that the patient is colonized/infected with a multidrug-resistant organism.

There are no special precautions for pregnancy listed in the Control of communicable diseases in man 18th edn (2004) or in any other textbook that I have checked.

Regards Adrian Watson

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#7 Posted : 08 February 2007 22:53:00(UTC)
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Posted By Chris Packham
David

You can contact me on 01386 832 311 or chris.packham@enviroderm.co.uk

Chris
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#8 Posted : 09 February 2007 09:52:00(UTC)
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Posted By jackw.
Hi, contact your local NHS infection control nurse for advice.

Cheers
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