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Re: MRSP

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Laurie,

We began to see resistant bacteria about 5 years ago in patients coming from the

larger referral centers. Postop ortho patients and cystitis in SCI patients.

We have cultured MSRPs, VREs and resistant E. coli. In my primary care practice

we have cultured MSRP on deep pyodermas and otitis externa. I have culture MRSP

in two of my own orthopedic surgeries more recently, so I know that it is in my

hospital.

Protocols

1) aggressive management and culture of pyoderma in rehab patients

2) close monitoring of SCI patient w/ periodic u/a and culture if needed.

Periodic measurement of post-elimination bladder volume and appropriate meds for

bladder management. In SCI patient that are not completely voiding and/or have

hx of resistant bacteria we use methionine and methenamine.

3) periodic cleaning of underwater treadmill but I am not of the opinion that

this is source of problem as long as those patients with active infections are

not allowed access.

4) zoonotic education of staff and clients

Rick Wall, DVM

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There is a blog that covers infectious diseases including MRSA/MRSP - the author Dr. Weese is quite knowledgeable on the subject and may be a worthwhile contact.  The blog is www.wormsandgermsblog.com

Sara

Laurie,

We began to see resistant bacteria about 5 years ago in patients coming from the larger referral centers.  Postop ortho patients and cystitis in SCI patients.  We have cultured MSRPs, VREs and resistant E. coli.  In my primary care practice we have cultured MSRP on deep pyodermas and otitis externa.  I have culture MRSP in two of my own orthopedic surgeries more recently, so I know that it is in my hospital.

Protocols

1) aggressive management and culture of pyoderma in rehab patients

2) close monitoring of SCI patient w/ periodic u/a and culture if needed.  Periodic measurement of post-elimination bladder volume and appropriate meds for bladder management.  In SCI patient that are not completely voiding and/or have hx of resistant bacteria we use methionine and methenamine.

3) periodic cleaning of underwater treadmill but I am not of the opinion that this is source of problem as long as those patients with active infections are not allowed access.

4) zoonotic education of staff and clients

Rick Wall, DVM

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