PIAC Case Series
Case 03 - Owen, 58 years old
Owen is a 58 y/o who underwent ORIF L tibia and fibula following a closed ankle fracture. He is readmitted 6 days post-op with wound dehiscence, drainage and surrounding cellulitis
Blood cultures are negative but wound cultures show PMN and gm + cocci on gm stain and grow MRSA
1) What isolation precautions should be taken to prevent spread of MRSA in the hospital?
- Should staff wear masks to enter?
- Should staff or other patients be cultured?
2) The patient undergoes debridement with removal of hardware and placement of external fixator; he is responding to iv vancomycin. Because of pre-existing DJD, a R total knee replacement is scheduled in 6 months. The patient, his family and doctors have several questions.
- Does MRSA pose a risk to his family/friends?
- What are the criteria for discontinuation of contact precautions?
- What measures can be undertaken to decrease risk of MRSA infection at TKA site?