PIAC Case Series
Case 03 - Owen, 8 Years Old
Owen is a 8 y/o who underwent ORIF L tibia and fibula following a severe 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?
The patient undergoes debridement with removal of hardware and placement of external fixator; he is responding to iv vancomycin. The patient, his family and doctors have several questions.
2) 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 for future surgery?