Risk of transmission (germs) from severly ill grandmother

Question

Dear expert team,

currently I am very confused asking myself how I can manage the contact between my child (CF, 4 years, Pseudomonas negative, from time to time colonized with Staph. aureus and Haemophilus influenza) and the grandmother.

My mother has end-stage carcinosis. Until a short time ago she went to the hospital (in-patient and out-patient) several times.

Currently an external bridge nurse is taking care of her at home. Is it possible that she is a "transmitter"? Is there a certain risk of transmission for my son from his grandmother? Especially what MRSA is concerned? Can we do anything against it?

Many thanks for answering.

Answer

Dear questioner,

Staphlyococcus aureus is a pathogen that is most frequently transmitted via the hands. The persons (healthy or ill) that are colonised by this pathogen are most commonly colonised in the nose. From there, the pathogen is transmitted to other parts (surfaces) of the body, for example to the hands. This applies for the sensitive pathogens but also for the more resistent Staphlyococcus aureus. Therefore, a good hand hygiene is the most important possibility to limit the spreading of the pathogen. If the grandmother is commuting between the hospital and the apartment or has a bridge nurse who is taking care of her there is a risk of a possible transmission. The safest way would be to find out if the grandmother is colonized. This could be done by having a nose or throat swab done. However, since the grandmother has new contacts with other persons again and again, such swabs would have to be repeated regularly. Most likely, this is not practicable and will not be paid by the health insurances. This way, there is a certain risk indeed. One possibility to minimize the risk would be to wear a surgical mask and to do a very good hand hygiene before and after the visits. A possible transmission cannot be excluded, though.

Best regards,
Barbara Kahl

24.01.2013