Elizabeth Biesemeyer asks whether milk from a mother under treatment for a
wound infection with MRSA may be stored with the milk of other mothers, in
the same fridge.  The mother is taking antibiotics.

Normally hospitals have isolation regimens for various infectious organisms,
and I would certainly want to make sure that the plan for this mother was in
line with hospital procedure for MRSA.    Where I am, MRSA requires strict
contact isolation, and nothing that has touched the patient may be taken out
of the room except in sealed bags.  They are served meals with disposable
plates and utensils, and their linens and clothing are double-bagged and
specially marked before going to the laundry.  Milk collection sets would be
decontaminated before being put into the ward cleaning/disinfectant system.
We treat everything as potential sources of contagion until a post-treatment
culture is negative.  I know of a documented case of a woman whose milk
cultured positive for MRSA, though the site of infection was not her
breasts.  

Where is the baby?  How is the milk getting sent to the baby?  How is she
cleaning her pump parts between expressing?  A portable cooler, placed in
mother's room, might do the trick, with some way of bagging the expressed
milk in its containers, for transport to the baby, but whoever is taking
care of the baby would need to know how to handle the containers so as not
to put themselves or the baby at increased risk.  It's not the milk that is
the problem, so much as the fact that the outside of the container must be
considered contaminated, and so anyone handling those containers should not
be touching any common contact points on the ward, especially not the fridge
handles for the breastmilk fridge.  It wouldn't take much to get the MRSA
neatly distributed among all the mothers who are expressing milk.

Rachel Myr
Kristiansand, Norway

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