Staph infection turned MRSA from spider bite on hip. Can I still get implants? Tests came back neg after antibiotics. Will I need to be on antibiotics before and after surgery?
Implants ~ MRSA Tests Came Back Negative, Am I Good To Go?
Doctor Answers 10
Breast Augmentation with history of MRSA infection
In the case of MRSA, an ounce of prevention is better than a pound of cure. If you had an MRSA infection and after antibiotic treatment the culture came back negative and the wound has healed, you are still considered as being colonized with MRSA. You are more prone to have MRSA infection after surgery if you do not follow properly the decolonization and suppression prophylaxis. We have done Breast augmentation and other surgeries on our patient with similar past MRSA infection with absolutely no reoccurrence of infection with the following decontamination protocol. We instruct our patient as follow:
1) Clean and disinfect rooms and surfaces at home with Lysol.
2)Five days before surgery, shower every morning and night with 4% Chlorhexidine(Hibiscrub), specially the underarms, groin, perineal area(between legs).After shower ,clean clothing and towels should be used.
3) Two days prior to surgery, start Mupirocine (Bactroban nasal ointment) inside the nostril and massage outside the nose 3 times daily for 2 days before and 3 days after surgery
4) Morning of surgery shower with Hibiscrub, use Mupirocine nasal ointment and we start IV antibiotic(Vancomycin) one hour before surgery.
The best advice for you is to inform your plastic surgeon about your MRS infection and only follow his recommendation to decrease your chance of infection. The protocol describe above should not be considered as medical advice and are only for information purpose.
Timing of a Breast Augmentation after a Staph MRSA infection
MRSA is a staph bacteria which is resistant to Pencillins. This makes eradication of these infections much more challenging.
Since all man made implants are not living tissues with a blood circulation which can fight infection, any infection in the body can migrate to the implants and attach to them permanently creating a biofilm layer of bacteria which NO antibiotics can get rid off. As a result, most Plastic surgeons would prefer to wait until ALL signs of infection are eradicated before considering such an operation.
I would wait until ALL wounds are healed and make sure there are no other sources of these bacteria on your body before placing Breast implants in you.
Peter A Aldea, MD
MRSA infections can be hospital or community acquired, like yours. The 2 strains of bacteria have different properties. Almost all of the strains in community acquired forms produce a toxin that targets white and red blood cells. They are more common in crowded living conditions, participation in contact sports, recent antibiotic use especially if prolonged, diabetics, unsterile tattooing practices etc. About 25% of the community acquired forms require hospitalization for treatment. The bacteria are transmitted by person to person contact or via inanimate objects. It is unclear if previous infection lowers the risk of developing another infection due to immunity. That individual though may still be a carrier who can infect other people. In the community these infections commonly initially appear as an insect or spider bite even though the individual may never have been bitten. Topical antibiotics have been proven to reduce colonization by these bacteria in the nose of carriers. However the effect is only temporary and the bacteria will become resistant to the topical antibiotic. Currently there is little justification to support decolonization maneuvers in the community. It is more likely that if you are a carrier of the bacteria that you would pass it on to someone else than get infected yourself once more with the same strain. The recommendations for preventing MRSA in the community are personal hygiene with daily showers, frequent hand washing, cleaning shared equipment especially athletic or gym equipment), clean contaminated surfaces and use a barrier between your skin and contact with any shared equipment that is used by lots of other individuals. My experience obtaining armpit, nasal and groin cultures in people believed to be carriers has not been fruitful and did not help in any medical decision making by me.
You would be given antibiotics by most surgeons during and after surgery even if you had not had a previous infection. In your case it would be most prudent to make that antibiotic one that affects most skin surface bacteria as well as MRSA.
My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.
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MRSA should be all gone but extra precautions are needed.
Glad that you have healed and your culture results are negative. It is likely that your physicians are on top of the reasons and the need to be vigilant with this difficult bacterial cause of infections. MRSA is just one of many bacteria that can be harder to treat and eradicate when it is identified. MRSA has fewer treatment options as you have learned. Any infection that develops around a breast implant usually results in the long term or permanent removal of your implants. A good reason to keep your risks as low as possible. If your surveillance cultures are negative (usually from nose, throat and any skin lesions) on more than one occasion that are separated by a few months, then you should be fine to move ahead with your surgery. Antibiotics given around the time of your surgery will further lower the risk of an infection developing.
Implants and infection
I would wait until all the wounds on your body are healed before having any elective surgery, especially breast augmentation. MRSA inection can be difficult to resolve and you may be a carrier in your nose, belly button, or someone in the household may be a carrier. I agree to see an infectious disease doctor and they usually want to treat you as a carrier and have your house cleaned and sterilized.
Implant infection rates are very low bur it is a real disaster to have and infected implant. It may lead to several other surgeries to remove the breast implant , resolve the infection, and then replace a breast implant.
Leo Lapuerta Jr. MD
MRSA & Breast Implants
If the spider bite wound which was infected with MRSA has healed and cultures are negative, you should be able to undergo an augmentation mammoplasty with a very small chance of devoloping an infection. I give all implant pattients intravenous antibiotics one hour before making the incision and very rarely give post-op antibiotics. I might change the pre-op antibiotic given in your situation. I would also agree with obtaining a clearance from your ID doctor.
Breast Implants after previous MRSA
It is quite common for those with a MRSA infection to be carriers of MRSA in their nose. The treatment for carrier status is Bactroban (Mupiricin) ointment in the nares for 10 days. If your culture is negative, I would recomend treating your nose prophylactically and going forward with the planned breast augmentation.
You can get implants after your bite site healed
You need to wait and make sure there is no active infection and all the wounds are healed before any implant placement.
Antibiotics post surgery
I would check with your infectious disease specialist. MRSA is not a bug, that we like to take chances with especially when placing an implant. Usually a waiting period, and then a decolonization to minimize the chances of the bacteria resurfacing is the way to go.