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Date: | Sun, 6 Mar 2011 11:32:03 -0600 |
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The woman who is a MRSA carrier should be treated as any normal
breastfeeding mother. Many people carry MRSA and don't even know it. In
fact 35-50% or more of people carry staph aureus in the nose, and now
that MRSA is so prevalent, most of that staph is now methacillin resistant.
The OB probably is screening her because hospitals have strict rules
about known MRSA carriers. They have to be isolated when they are in the
hospital.
Her baby will be exposed to MRSA because she is a carrier, but really
who cares, since anyone who holds her or cares for her, such as
relatives or the hospital nurses, could also be carrying MRSA.
If she develops a breast mastitis or nipple infection the doctor must do
a culture and r/o MRSA, so that she is treated with the right
antibiotic. In fact, if she develops a breast infection, the first
antibiotic to consider is TMP sulfa or other antibiotics appropriate for
MRSA. Sensitivities are important to do, since MRSA might or might not
be sensitive to clindamycin, which is useful for a severe mastitis.
If she develops nipple sores, I would have her use mupirocin ointment
prophyllactically to prevent a deeper breast infection.
She does not need to stop nursing if she develops a MRSA mastitis, it
should be treated like any other mastitis, but it is important to know
that MRSA mastitis patients are more prone to abscesses.
She will not asymptomatically infect her baby with MRSA.
I hope this helps.
Anne
Anne Eglash MD
Clinical Associate Professor
Dept of Family Medicine
University of Wisconsin School of Medicine and Public Health
600 N. 8th St.
Mount Horeb, WI, 53572
608-437-3064 (O)
608-437-4542 (fax)
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