Expert: Dr Ian Jackson - please note UK based - 2/19/2008

Question
Hello -

I had an outbreak of CA-MRSA back in 2006.  I have had 2 negative nasal swabs, and 1 positive, and I am about to have a c-section in a week.  Can you tell me what the general dangers are for me to have a spinal block since I am colonized with MRSA?  Is there a chance that the MRSA will be introduced to my spinal fluid and thus cause a systemic infection, or is the concern strictly for a skin infection?

Thank you

Answer
Hi there
I have just looked after an elderly lady with MRSA and I gave her an epidural for her operation. Just because you have an antibiotic resistant strain of staph aureus does not make it immune to normal infection control methods. I merely prepared the insertion site even more meticulously than normal. I would suggest that if it is safe for you to have a cut on your abdomen for a c-section then it is safe for you to have a spinal.
I hope this helps put your mind at rest.
Dr Ian Jackson
ps I suspect the incidence of incidental finding of MRSA colonised people in the community is rapidly increasing and so you are not alone - you merely know about it when probably many others don't.