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Ask Anthony Bray, MD Your Own Question

Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 6704
Experience:  14 years as clinician in the field of Family Practice
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I have a daughter that had a VSD and an ASD repair and the

Customer Question

I have a daughter that had a VSD and an ASD repair and the aortic valve leak repaired. She still had a communication coming thru in her yearly check up with her neonatal cardiologist which he says is that slight leakage coming from the heart on one of the wholes they couldn't repair completely during surgery. The whole was below the heart tissues too deep to get to. She has been fine but still has check ups with the cardiologists. She is still ordered to take antibiotics when seeking dental work. Recently her Dad got cut on the leg and contracted staph and has had it and treated it thru his family dr and without much luck. It has since went to a open type wound on the forehead and he went back again and the dr said he had a mad type of staph and continued to pull a culture and we are waiting for now. He has continued him on the same antibiotic and we are waiting but I am concerned after 6 weeks of trying with same antibiotic and for my now 10 year old daughter who had this ASD and VSD repair at 9 mo.
Submitted: 4 years ago.
Category: Health
Expert:  Anthony Bray, MD replied 4 years ago.

Hello!

 

 

It sounds that her father has contracted a resistant staph species which is probably MRSA(Methicillin Resistant Staph Areus) This does posses some risk of transmission through direct contact. It would be prudent to clean surfaces with a solution of clorox and perhaps obtain Hibiclens for washing hands.

 

MRSA would usually be sensitive to Septra, Zyvox or Vancomycin( the last one is given IV but the first two are oral) Just because he has this infection does not mean that she would contract it. Staph germs are ubiquitous and always on our skin. We occasionally go from a colonization to infection if there is a compromise of the usual defenses such as the wound her father suffered.

 

If she should develop an infection from a Staph germ then the skin would be the most common type of infection with this bacteria. Aggressive treatment would be advised for her with her heart history. Most skin infections don't cause bacteremia(bacteria seeded into the bloodstream) but severe skin infections can (cellulitis, deep wound infections). Bacteremia in your daughter would indeed be dangerous and could result in endocarditis(an infection of the heart). This overall would be an unlikely scenario but not impossible. Due vigilance to prevent skin /surface contact and to employ the measures to prevent infection are recommended.Watch for any skin infection on her and treat early and aggressive would also be my recommendation.

 

I hope this information helps. Further questions are welcome if you have others. If my answer has been helpful and to your satisfaction then please remember to press the "ACCEPT" button. Thank You and Best Regards,

 

Anthony Bray MD

 



Edited by Anthony Bray MD on 8/1/2010 at 12:39 AM EST
Customer: replied 4 years ago.

at no time has myrsa come up and is and has been on septra for the entire time and his staph had moved to his forehead a week ago. now a total of 6 weeks today.

although I had forgotten until now that this is not good for my daughter since I was down in my back for these weeks so to say that I bleached things NO! and his dr asked him to leave it open after 2 1/2 weeks to drain so she would be in direct contact does that mean she has a greater chance or not?

 

Expert:  Anthony Bray, MD replied 4 years ago.

Hello again,

 

She is probably not at high risk although she would be at some increased risk. I would recommend that he use something topical on the open wound. This could include a prescription antibiotic ointment that is usually active vs. Staph bacteria such as bactroban or Altebax. He could obtain Hibiclens OTC in a drugstore. This is a skin cleanser that would be active to kill the Staph germ. A bleach solution might be prepared in a spray bottle and used to quickly spray and wipe down surfaces such as doorknobs and bathroom counters for example. These measures would help reduce the risk of transmission. If he washes his hands after cleaning the wound with an antibacterial soap or solution then this would help. ((I like the Hibiclens as this is used also as a presurgical scrub))

 

I would not think that she would be in direct contact with his wound of course but it would be the secondary transfers to watch for. He applies ointments to the wound or cleans it then his hands are contaminated and he touches surfaces such as the bathroom counter. It is this type of secondary transfer that we want to interrupt and protect against.

 

I hope this information helps. Further questions are welcome if you have others. Best Regards,

 

Anthony Bray MD

Customer: replied 4 years ago.
so if this were your child what would you do?
Expert:  Anthony Bray, MD replied 4 years ago.

Hello!

 

If this were my child I would do exactly as I have advised. I would take extra steps to clean the skin of the active infection. I would take extra steps to clean common surfaces such as the bathroom counter, kitchen counter, doorknobs and possibly phone.

 

I would have her wash her hands with an antibacterial soap before meals at least.

 

I would inspect her skin to make sure that I saw no signs of a skin infection (pustules, sores, impetigo---this has a crusting appearance)

 

Have the Dad wash his hands several times a day and especially after cleaning the wound.

 

It is helpful to realize that the same bacteria is constantly colonizing our skin BUT his wound infection introduces a potential for a high number of these bacteria and this exposure is best avoided to the extent reasonably possible.

 

If the Dad were a patient in the hospital with this infection then a sign would be placed on his door indicating "Contact Precautions" to alert the staff to take steps to avoid transfer of the bacteria from him to other patients. This type of infection would not be airborne but it can be transferred by contact.

 

I hope this information helps. Further questions are welcome if you have further. Take care,

 

Anthony Bray MD

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