Natural Science Forum / Biology / Microbiology / February 2005

Dear group,

I am not sure if this is an apropiate group for my questions, so I
appologise if I am asking them at the wrong spot. In addition, I am a
non-native speaker of English and a lay person, although I get UTIs on a
regular basis, so I am slightly more knowledgeable than the general public.
I am a 33-year-old male with spina bifida, and the associated bladder
dysfunction causes intermittent UTIs. Recently, I got one again, and as I
had a seriouis fever, I was prescribed Norfloxacin without a usual culture
being evaluated. The symptoms disappeared at first, but a few weeks later,
they came back. As the fever was much lower than at first, now a sample was
taken and analysed in a lab for microbiologyand I did not tske anything
during the waiting period.
According to the definitive results, it contained leucocytes (fair
enough...) and "negative staves/rod-shaped bacteria/bacillae" -  I only have
the Dutch print out and I'm not sure how "staven" translate in this context.
The detailed culture analysis showed >10E5 mo/ml E. coli (a bug I am quite
familiar with, obviously), and on the second line it says "ESBL + >10E5
mo/ml ". I am not sure if this is a second bacterium (it is both under one
number/heading) or a possible characteristic of E. coli.
Now I was instructed by my GP (indirectly as I was not there when she rang
to give the result so someone else took the message) that I had MRSA, which
I know to be a serious "hospital bacterium". By the way, on the record of
which I got a copy today, it only says that it is "COMPARABLE TO" MRSA. As I
need regular assistance by a district nurse (I am NOT hospitalised), I
informed them yesterday that I got the lab result and that it showed MRSA,
but that other than a VERY MILD cough I had no symptoms whatsoever. Now they
are taking all kinds of protective measures like wearing a special apron and
cleaning their hands with alcohol or some similar substance instead of
ordinary soap. There is no consensus on the need of mouth masks.
Although I don't feel ill at all, I decided to take the prescribed meds
(Trimethoprim, other options would have been Nitrofurantoin and
Cotrimoxazol, so it is not quite as scary as an MRSA requiring Vancomycin)
in an attempt to eradicate this bacterium/bacteria so that the protective
measures can be lifted ASAP.
Now my questions are the following.
As I don't have any symptoms, am I contagious in a nursing context OUTSIDE
of hospital when regular examination gloves are worn but no extra measures
are taken? Of course, the nurses go from one patient to the next, but they
decided to help me at the end of their round. Is it reasonable to treat a
non-symptomatic carrier as a patient who has an infection by this bacterium?
Am I contagious in normal social contacts? I was told not to visit hospitals
or polyclinics (out-patients departments) without mentioning the infection,
but it was no problem to visit the GP surgery when necessary. Would there be
a way to ascertain if I got the bacterium from a district nurse who got it
from another patient, or I rather got it from an "outside" source?
I realise that it may be difficult to make statements without seeing the
"patient" (I don't feel like a patient at all!), but I hope someone here can
give me some information concerning the risks in this case.

Kind regards,

Jasper.