MRSA Carrier - Colonized - Soft Tissue Infection - Decolonization
Pathogenic Contagion: MRSA - Methicillin Resistant Staphylococcus Aureus
"Carrier" and "Colonized" mean the same thing. Being colonized with MRSA makes you a carrier.
Photo courtesy of Energy Future Holdings Corp., Dallas, Texas.
Carriers are contagious and can easily spread the MRSA bacterium. A carrier may or may not be outwardly affected themselves,
but can spread and contaminate others who can develop illness and infection. Colonized individuals are called asymptomatic carriers
when the carrier does not develop illness. Some carriers may have had soft tissue skin infections which heal, and they do not experience
illness any longer, but can still be colonized, carrying the MRSA bacteria, and can still spread the bacteria contaminating others.
Colonization refers to the presence of microorganisms on or in a host with growth and multiplication, with or without tissue invasion or infection damage.
MRSA colonization can serve as a reservoir for the spread of the microorganisms to others, and can lead to infection in the host or others by way of cross contamination.
Soft Tissue Infection is the entry and multiplication of microorganisms in the tissues of the host leading to local or systemic signs and symptoms of infection. In the case of
MRSA, the body site most commonly colonized is the anterior nares. Other body sites that may be colonized with MRSA include perineum, axilla, upper extremities, umbilicus
(in infants), open wounds, the respiratory tract, and urinary tract. MRSA can cause invasive and life-threatening infections, such as osteomyelitis, bacteremia, endocarditis,
pneumonia, urinary tract infections, intra-abdominal or pelvic infections, sepsis, wound and surgical infections.
Decolonization
Bactroban/Mupirocin 2% - and OTC Bacitracin Ointment: Since we are dealing with antibiotic resistant bacteria, same over-use concerns hold true of topical antibiotic ointments
when considering issues of resistance. It is important to use topical antibiotic ointment for the full course of treatment. Typically 2x daily x5 days. Failure to use such products judiciously
may decrease the effectiveness of this treatment, and may increase the risk that the bacteria will no longer be sensitive to Bactroban/Mupirocin or Bacitracin ointment. In this case MRSA
will not be able to be treated by these or certain other antibacterial medicines in the future. Each of the above ointments contain antibiotic properties. They work by stopping or preventing
bacterial infections by either killing susceptible bacteria or inhibiting their growth.
About Phisohex
Phisohex is an antibacterial sudsing emulsion for topical use. Although Phisohex does have favorable results against MRSA, it was pulled from the market back in the 70s due
to the hexacholorphene content which is a neuro-toxin capable of causing neurological damage, developmental delays, and learning disabilities. The active ingredient in Phisohex is hexacholorphene,
a powerful antiseptic. BUT, an inevitable part of the manufacturing process leaves residual amounts of Dioxin which can be absorbed through the skin. Since there is this additional risk when using
Phisohex, most MRSA suffers eventually turn to Hibiclens or equivalent which contains Chlorhexidine Gluconate Solution 4.0%.
About Hibiclens
Hibiclens is an antiseptic antimicrobial skin cleanser possessing bactericidal activities. Chlorhexidine topical is an antiseptic which destroys germs on the skin and is often used before surgery to reduce the
risk of infection. Chlorhexidine topical may also be used to treat acne. Same over-use concerns apply to cleansing one's skin with such products. Resistance if over used is a very real concern and consideration
should be taken in limiting use as it is quite feasible to wash away both good and bad bacteria, creating a perfect environment for the bad bacteria to capitalize on. Balance is the key!
Resistance Factor
No one can say "non-stop use" of Bactroban / Mupirocin, Bacitracin, Phisohex, and/or Hibiclens (which we know may temporarily clear one's MRSA infection) hasn't increased the risk that the MRSA bacteria will
become resistant to these products rendering them no longer sensitive, leaving the individual MRSA positive carrier status even with continued daily use. This is where resistance issues must be considered. The
only way known to prove one is not harboring MRSA as a carrier is to have cultures done to determine nasal carriage carrier status. This is accomplished with three consecutive nare cultures to the standard of today,
being three repeated negative results. Even then there is in-vitro lab data on the board concerning "false negative" and "false positive" results. Also, negative "nasal" carriage doesn't mean one is not positively colonized at
other body sites such as perineum, etc. rendering them positive colonized/carrier status.
This would be an inaccurate statement... ["When a person is colonized but not infected, there is a 0 percent chance of contacting MRSA from that carrier if and only if the carrier is continuing to use a decolonization regimen.
That doesn't mean, either, that the carrier is decolonized."]
If one has built resistance to topical antibiotic ointments you can conduct the decolonization regimen until the end of time to no avail. As stated above "a carrier=colonized with the MRSA bacteria, is one who must deal
with the contagious factor as well as resistant factor, and should conduct themselves as such with precautions just as when one does when MRSA infected." It is possible to decolonize, which means one is not carrying the MRSA
bacteria in their nares, on their skin, etc. proven by cultures, this is true of those of us who "attempt" to decolonized during the 5 day period using Bactroban/Mupirocin 2xs daily x 5 days. Even if one is successful at decolonization
one can also go from decolonized/non-carrier status, to colonized/carrier status, the moment one as a non-colonized/non-carrier goes out in public and contracts the bacteria becoming re-colonized directly.
One may for the sake of this discussion and caution... have over used these products to the point of decreasing their sensitivity (effectiveness), only to increase the risk that the bacteria is no longer sensitive to topical antibiotic ointments,
giving a false sense of security believing that one does not have the ability to be contagious because of their ongoing decolonization regimen. This is simply not true. If you are a carrier you are colonized, and if you are colonized you
are contagious, having the ability to spread MRSA.
This is why hospitals are jumping on board to pre-screen MRSA colonized/carrier status patients during admissions, and when positive culture results return, their surgeries or procedures are canceled and they're sent home with 5 day
decolonization prescriptions as prep prior to rescheduling surgery/procedures. MRSA positive colonized/carriers (if known) who work in establishments such as hospital, nursing homes, the public arena, in some locations across the US
must submit to (3) consecutive negative nare cultures before they can return to work once it is established they are positive MRSA colonized carriers. The notion MRSA is a public risk contagion is catching on.
Specialists who state...
["My specialist confirmed that if I didn't have an outbreak after approximately 3 months, and continued to religiously wash with Phisohex and apply Bacitracin daily, I as a carrier, cannot be contagious." ] ["THE BACITRACIN SHOULD BE
DONE EVERY DAY FOR THE REST OF MY LIFE. Also, he stated that his regimen makes patients zero percent contagious - it's impossible to infect someone while using this regimen."]
I would challenge him/her to explain the issue of antibiotic resistance vs non-resistance, as well as prove his/her statement with the current medical standard of (3) consecutive negative cultures. This can only be accurately accomplished
when you have "discontinued antibiotic orals and topicals." Only when (3) negative culture results return should you put any weight on results. Sorry to say even then there is the issue of "false negative"and "false positive" nasal culture results -
so we already need an improved more accurate test that does not carry the "false negative" and "false positive" issues. False results is one reason why so many Infectious Disease specialists do not believe in nasal cultures. They are also not so eager
to decolonize patients, since one simply has to go out in public to contract the bacteria again becoming re-colonized, because MRSA is so prevalent in our society today. As stated previously, even if nasal carriage is negative you may still be
colonized elsewhere.
Side Note: The popularity of this page has not gone unnoticed. Therefore, we would like to extend an invite to any who wish to establish dialog with other MRSA sufferers through our forum...
MRSA Discussion Forum USA and Canada
