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Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 7164
Experience:  14 years as clinician in the field of Family Practice
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Hi I was wondering if you were familiar with mrsa studies especially

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Hi I was wondering if you were familiar with mrsa studies especially relayed to healthcare workers and them passing it to their family and pets?
Submitted: 1 year ago.
Category: Health
Expert:  Anthony Bray, MD replied 1 year ago.

Anthony Bray MD :

Hello!


 


No , I can't say that I am specifically familiar with studies on the topic that you describe....


 


 

Anthony Bray MD :

It would be true that you are more likley to pick up MRSA if you work in the healthcare field however...

Anthony Bray MD :

You are more likley still to pick up MRSA if you work in the hospital and most likley if you work in the ICU... a respiratory thrapist has a high risk of contact with MRSA...

Anthony Bray MD :

If you have a patient known to have MRSA or a staph infection then this calls for contact precautions of course...

Anthony Bray MD :

You can take steps to reduce the risk of skin colinization of MRSA or staph germs in general by cleaning surfaces such as counter tops , kitchen areas and bath areas and doorknobs regularly with a bleach solution....

Anthony Bray MD :

You can opt if you should work in a high risk area to reduce this risk by bath once a week with a solution of 1/2 cup bleach in 2 and 1/2 inches of bath water... this will killl staph bacterai which do commonly colonize our skin...

Anthony Bray MD :

This is usually not necessary to avoid infexctions but if you should work in a high risk area such as an ICU then I would take these prevention steps....

Anthony Bray MD :

I hope this is helpful to you!

Anthony Bray MD :

I wish that I could quote you more specific study info but I am not specifically aware of recent studies on this topic...

Anthony Bray MD :

Best Regards!

Anthony Bray MD :

Anthony Bray MD

Customer: Thanks so much, I was not able to type my question out in the small box around your name, but the reason I ask is that I am wanting t buy a puppy from a breeder and this breed is notorious for being used as therapy dogs. If I do find a non therapy dog then they are usually in the health field and I have really read up on studies where a huge amount of healthcare workers are affected which led me to research whereas they can bring it home and to the pets and I was worried it would affect me in buying the puppy where they would be kissing, and loving on the puppies ect
Anthony Bray MD :

I see... well in general I would say that pets should not be that high risk as far as exposure.. I do not recommend "kissing them on the mouth" as a matter of practice however! You raise an interesting point that if a pet were kept in a high risk area then expsure and transfer to MRSA would be possible. If you purchase or otherwise obtain a puppy then it would seem unlikley that this animal would be likley to have had such exposure however...

Anthony Bray MD :

Animals tend to carry their own particular native germs of the mouth >> a dog bite is about 10 to 20% likley to become infected whereas a cat bite is about 85 to 90% likley to become infected...

Anthony Bray MD :

Cats tend to have Pasturella bacteria in their mouth and this bacteria tends to lead to infection if exposure is under the skin...

Anthony Bray MD :

Simply petting a dog or cat is NOT high risk for infections in general though....

Anthony Bray MD :

I hope that this is helpful for you and your decisions in this regard...

Anthony Bray MD :

Best Regards!

Anthony Bray MD :

Anthony Bray MD

Customer:

http://www.mcknights.com/the rapy-dogs-can-transfer-mrsa-and-c-difficile-among-nursing-home-residents-researchers-say/article/136435/#

http://www.dailypuppy.com/articles/about-mrsa-staph-infections-in-dogs_1270.html

https://www.avma.org/public/PetCare/Pages/MRSA-FAQs.aspx


http://wwwnc.cdc.gov/eid/article/10/12/04-0387_article.htm
Some links from American vet assoc on mrsa in dog studies ect

Customer:

these are the ones that scare me

Customer:

there are many more, but these dogs are used in nursing homes and also the breeder that I want to get from are doctors, which no offence, but scares me! :)

Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

 

I am in the process of reviewing these articles. I will get back with you when I have had a chance to take a look at these.

 

Take Care for now! Anthony Bray MD

Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

I have had the chance to rview two of the articles and unable to reach one of them...

I think I understand your concern at this point.

You may wish to confirm for one that your puppy if you choose to obtain one has not been in a therapy role for one >> if not then this would decrease the risk that your particular animal could be colonized.

Two >If you obtain your puppy then I would think it reasonable to be extra cautious to wash your hands every time that you handled the animal with an antimicrobial soap (Hibiclens is available at pharmacies and this is what is commonly used for surgeons to scrub prior to surgery...) Extra precautions may be taken for the first three weeks that you have the animal. I am reading that the risk of MRSA colonization would diminish beyond two weeks of potential exposure...

So I think that these steps would keep you safe. KEEP IN MIND THAT YOUR CONCERNS TOO ARE ENTIRELY THREOTETICAL at this point ... we are not dealing with you asking about a current skin infection for example... so the risk to you is not as much as your fear is basically what I am getting at!!

I hope this helps!! Let me know if you have further questions! Best Regards,

Anthony Bray MD
Customer: replied 1 year ago.

Thanks, XXXXX XXXXX definately a "germaphobe" The closest I have found that doesnt use them as "therapy dogs" are actual healthcare workers that were breeders, and I was reading studies that healthcare workers are more at risk and was really afraid that if they were colonized and keep in mind they do the socializing of the pups. I'm terrified.

Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Well I understand where you are coming from but in this case I do think that your FEAR is really outstripping reality in terms of the risk to you!!

I hope that are able to manage your germ phobia and safely enjoy your new pet!!

Let me know if I may be of further assist. Best Regards XXXXX XXXXX!!

Anthony Bray MD
Customer: replied 1 year ago.
How about if I obtain one where the breeder themselves don't take to hospitals and nursing homes or use them as therapy dogs but two doctors live in the house and play with the dogs (being I read that healthcare workers have a large number if colonization?) case in point, my mother was talking to a dr and he told her HE himself had mrsa! Scarey stuff!
Expert:  Anthony Bray, MD replied 1 year ago.
Hell again!!


Well it is true that a doctor seeing patients will have a higher than normal risk of being exposed and so potentially colonized with MRSA. Keep in mind that MRSA is a subspecies of the staph germ. The staph germ is ubiquitous in nature. The main difference is the antibiotic resistance pattern. Now a daoctor will AT TIMES be COLONIZED with staph germs on the skin INCLUDING MRSA but over time the basic forms of the germ predominate. This is because in nature where there is an absence of antibiotics then MRSA has no advantage vs generic forms of staph... I have no doubt that I myself at times have been colonized but not infected with MRSA... we are all colonized by staph germs and the potential is there for boils or other infections (mainly of the skin with staph germs) that may occur over time....

(I have never had a MRSA infection as far as I know but have treated patients with this...)

So yes a doctor does have increased potential exposure and likewise their pets. Still the vast majortity of the time you shake hands with a doctor you are not colonized and the vast majority of the time that you may be colonized then this would tend to be for a limited period of time and NOT lead to infection. Colonization only occasionally leads to infection. I think that this is where your fear jumps way ahead...

I hope that this helps to clarify and not confuse you!

I know that MRSA is scary in its potential. I can't deny that doctors have increased levels of exposure potential to this germ. Still life in reality is not as dangerous as these discussions seem to make it!! Even doctors live normal lives!! If you get a pet from a doctor whom has bred the animal then in reality this does not bring you great risk!! It would have to be a chain of bad events. You can take reasonable steps to take increased precautions against staph and this would make you even safer....


I hope this is helpful! Please let me know if you have further questions or if I may be of further assist to you!!

Take Care,

Anthony Bray MD
Customer: replied 1 year ago.

Thank you so much for your explanation. I'm trying to find a "median" that I can "live with" (coming from my germaphobic nature) I want to be able to enjoy the dog, and actually have dogs now but theyve been with me for a decade and a half so none of this was "as" rampett then. I'm trying to find the lesser of the risks. One that takes the mommies and pops of the doggies to the nursing homes, ones that used to take them to the nursing homes, or the breeders that are doctors that have constant exposures ect? And if this is a good idea as we have had a run in with auto immune problems in the past. I just dont know what is risks or not? Am I overwhelming myself? But then again I dont want to just "lay if off as nothing" etc.

Expert:  Anthony Bray, MD replied 1 year ago.
Hello again!

Well if you have yourself an immune deficiency problem for some reason then you may have more reason to be concerned about this issue. I think that otherwise that you should be able to accept a puppy from a doctor that was a breeder and for your own peace of mind perhaps increase vigilance to wash your hands and perhaps even more ardently wash surfaces such as counter tops and doorknobs for the first two to three weeks that you have the new puppy.

I REALLY do not think that you need to be as concerned about this issue as you are however!! I think that you will be fine! I mean you make it seem as though doctors and their dogs are keeling over everyday due to MRSA infections and this is not the case. Yes staph infections may occur >> even MRSA usually has a few antibiotic choices such as Septra, Zyvox and if needed Vancomycin usually works vs this organism. It is not usually the case that there are no antibiotic choices against this type of infection. (In the worst cases it can be resistant to all antibiotics tested but this is usually NOT the case>> MRSA = Mehticillin resistant staph aureus and it is usually resistant to the most common antibiotics that are more often used in skin type infections... that is what is meant by MRSA...


I hope this helps. Let me know if I may be of further help! Take Care!!

Anthony Bray MD
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 7164
Experience: 14 years as clinician in the field of Family Practice
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Customer: replied 1 year ago.

Thanks, XXXXX XXXXX of course speaking, if the dog was colonized then what is going on in the first 2-3 weeks etc.? I know that I have a followup questions, but I'm going to go ahead and rate you so I dont forget, so you get credit, I just have been told so many things about MRSA, and family members have had it that are healthy and its really been serious, so I'm terrified! But then again, i think about if I get one from another breeder, they themselves might have MRSA you just never know. Its just a new ballgame I'm playing since its an introduction of "new". So when I read things like MRSA the 10th leading cause of death it terrifies me.

Expert:  Anthony Bray, MD replied 1 year ago.
Hello again!

If a dog were colonized with MRSA then that would simply mean that the bacteria lived somewhere on the pet at a given point in time...if the paws were swabbed or the nostrils or the fur then you would usually just get a mix of background bacteria. Occasionally such a swab might reveal MRSA but not the majority of the time by any means. MRSA emerges from the background of staph bacteria. As I said staph aureus is ubiquitous. You will have this bacteria living somewhere on your skin the majority of the time. It is on occasions that the bacteria becomes trappped in a pore and over-multiplies that it may cause infection >> most common would be the "pimple" or small skin boil....


The body constantly fights off infections without us taking any action. That is the job of our immune system. The majority of staph germs may feed on dead skin cells without ever infecting us. The majority of infections are so small that they are of no consequence suxch as a small pimple on the skin... on occasion a more serious infection may take hold. On these occasions if you should have a bad skin infection then this might be say a case of cellulitis a red sore area that is spreading under the skin>> you would see a doctor for such an infection and would need an antibiotic. The most common skin antibiiotoics may include one >> say Keflex as an example>> this kills most staph and strep but would not kill MRSA >> so a person with MRSA cellulitis treated initially with Keflex may as likley get worse as better... this is where the danger lies.


Such an infection may require different antibiotics. The high mortality rates that you find reported are from settings with patients that are to begin with very ill. They may have recurrent pneumonia dn may be sicker and sicker until they wind up in the ICU. This type patient is the type that may end up succumbing to a highly resistant MRSA infection for example. Also a chemo patient may be a victim. An AIDS patient may be a victim. A normal healthy person is not usually a sudden and tragic victime of MRSA though....

So it is through these type of pathways that may lead to deaths that relate to MRSA. IT is a common misconception that MRSA is an abnormally vicious germ more likley to infect vs generic staph. That is not the case. It is the case that at the end of the road for many patients they have gotten sicker and sicker for a variety of reasons and may end up in the hosptial and then ICU and may have been more and more exposed to antibiotics until finally the antibiotics become less useful. That is the reason for the mortality rates. It is not little puppies bred by doctors that are the real reason behind the danger of this type bacteria!!

I hope that this helps! Thank you for your accept and positive response. I greatly appreciate that! Let me know if you have further follow up questions! I will be happy to get back with you!

Best Regards!

Anthony Bray MD

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Anthony Bray, MD
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