Those patients at high risk for already carrying MRSA include:
* Patients with history of MRSA colonization
* Patients in Intensive Care
* Patients hospitalized in the previous 12 months
* Patients who have had extensive contact with a health care system such as nursing home residents, patients on dialysis, or patients receiving outpatient infusion therapy
* Patients who have received antibiotic therapy in the last three months
* Patients with skin or soft tissue infection at this time
* Patients with additional risk factors for MRSA which include family members with known MRSA colonization or infection
If you are at risk of already being an MRSA carrier yourself or exposed to MRSA, we may refer you for evaluation by an infectious disease specialist prior to the procedure. Showering with a chlorhexidine solution for several days prior to the procedure can help reduce the risk in all patients.
Risk factors for having acquired a resistant E. coli (one which is resistant to common antibiotics) include:
- Hospital stay
- ICU stay
- Presence of central venous catheters
- Having undergone emergency abdominal surgery
- Prior administration of any antibiotic
- Prior residency in long-term care facility such as nursing home
- Presence of urinary catheter
- Undergoing hemodialysis
ESBL-producing bacteria tend to reside primarily in the digestive tract. That is why this is a significant problem for our patients undergoing prostate biopsy.
Given the significant infections which can occur with these sorts of resistant organisms, it is critical that we be aware of your entire history of recent illnesses, antibiotics you have taken, and specifically if you have had infection with resistant organisms.
We do recommend bathing or showering with an anti-bacterial soap for a week prior to all procedures. Chlorhexidine solution is one of the best. Dial anti-bacterial soap and other hexachlorophene-containing soaps work reasonably well also.
If you have had proven infection, we do need to know that. We may need to have a consultation with an infectious disease specialist to determine your best course of therapy.
William F. Barnes, M.D.