To date or not to date: MRSA edition.

June 23, 2015 1:41 AM

I recently started hanging out with this lady. We have gone on 2 dates, and kissed. She told me, on the second date, that she has had MRSA in the past. It colonized her nose and she passed it on to her ex-boyfriend during an infection. She has not had an infection in 2 years, however. AM I SAFE

I mean I'm kind of a germaphobe, so this freaks me out. I do not want MRSA. But I totally like her! Should I suck it up and realize that the potential for infection is low? How likely am I to get MRSA? What if she has another infection and we make out and then I die?

Thanks as always in advance

posted by special agent conrad uno to Health & Fitness (17 answers total)

There's every chance you're already colonised with MRSA anyway. If you do become colonised from this person you will possibly clear it and never know. She may have already cleared it.

It's unlikely to cause an invasive infection if you have an intact immune system and don't participate in iv drug use.
posted by chiquitita at 2:29 AM on June 23, 2015 [9 favorites]

I'm a bit boggled that someone would even talk about having had MRSA. 'An infection'? Your nose contains a multitude of bacteria, a lot of which are completely willing to go nuts on your body when your immune system is low. Including Streptoccoccus. On the bright side, it is a gram-positive bacteria, which tends to be 'easier' to kill.

It is something which /can/ be addressed with the right antibiotics -- it Strep A (or B) can be entirely localised to one particular area of the body, for example, a wound. You get a swab taken, the lab figures out which antibiotics it's sensitive to, and then it can get knocked out. When people are in contact isolation in hospital for MRSA, it's to protect the really sick other patients rather than the staff -- people who are healthy can be colonised without issue.

Do you have health issues which can cause a decrease in your immune system? If not, I'd not be too concerned. A lot of people, unfortunately, have MRSA, including in all likelihood your local friendly doctor -- a hazard of being around ill people.

Now, if she'd said that she had CRAB ... I'd be more worried ...
posted by owlrigh at 2:30 AM on June 23, 2015 [8 favorites]

Response by poster: what is CRAB i am not even going to google it

My immune system is healthy, and I have no other (known) issues. Aside from my perfectly normal raging paranoia
posted by special agent conrad uno at 2:48 AM on June 23, 2015 [2 favorites]

MRSA is just a particular strain of golden staph whose defining characteristic is resistance to certain antibiotics. It's not any more GRAR EAT BODY than other golden staph strains commonly found on your skin or up your nose, just a little harder to treat if it does colonize a wound.

There's a very high chance that you've been both hosting and killing off endless amounts of golden staph your whole life without even realizing it.
posted by flabdablet at 2:54 AM on June 23, 2015 [18 favorites]

Many people have staph in their nose, including MRSA. You might have your own happy little MRSA colony hanging out in your snot right now. Don't freak out.

I had a MRSA infection two years ago, serious enough to require a doctor visit but not serious enough that I was in mortal peril. It responded to antibiotics (just not the methicillin kind) and I didn't pass it to my husband or anyone else. I'm pretty paranoid about all the ways I could get hurt or sick or dead at any moment, and MRSA doesn't register on my personal list of things to panic about. Practice regular common-sense hygiene and you'll be fine.
posted by Metroid Baby at 4:01 AM on June 23, 2015 [5 favorites]

A lot of people probably have staph and don't even realise it. I guess she was trying to be responsible in telling you, especially since she gave it to her ex at some point, but please try not to over think it.

Even if she does give it to you? If you have a healthy immune system, you're not going to die from this.
posted by kinddieserzeit at 4:51 AM on June 23, 2015 [2 favorites]

I've had MRSA in my nose (because people touch their noses all the time) and it was pretty bad, but I never once considered, after the infection cleared, it to be something I'd have to worry about later on in my, or anyone else's life. It's an infection. It's something that, if you get it (more likely to get it from gym equipment or a shopping cart than your girlfriend while kissing, several years after she had it), you'll get medication for.
posted by xingcat at 6:28 AM on June 23, 2015 [1 favorite]

Yep, you may already have MRSA in your nose and not know it. Lots of people do. Breathe. It's kind of overly conscientious of her to disclose, but I'd say that's a good sign in your case -- she's told you about something she may no longer have that you are probably not going to catch from her, so she's probably not concealing an active herpes or HPV infection, or she'd tell you that, too.
posted by fiercecupcake at 6:28 AM on June 23, 2015

Nthing it's no big deal as long as your immune system is relatively intact. As a nurse who works in a hospital, my coworkers and I pretty much presume we are all colonized. We try to be careful, but it's so common now that assuming the only patients who have it are the ones on active MRSA precautions is a joke (imo). Many (? most) people who are colonized never become ill and never even know they have it. In fact, theoretically, you could already be colonized, she could have cleared hers, and you could give it to her!
posted by shiawase at 6:29 AM on June 23, 2015

Getting tested is easy. The only reason to be tested is if you have a compromised immune system, or if you hang out with infants, old people and/or people with compromised immune systems. I got tested(negative -woo-hoo) because I was spending time with an infant.

It's never a bad idea to eat healthy and wash your hands frequently. Otherwise, keep calm and, you know.
posted by theora55 at 7:01 AM on June 23, 2015 [1 favorite]

Umpteenthing the others saying you may already be a MRSA carrier.

Years ago, during a visit to the ER for an unrelated injury, the nurse did a quick swab of my nose (apparently, they did this to everyone at the time) and, lo-and-behold, I was a MRSA carrier. I've never had any symptoms. But, it's something that's important to know about yourself.
posted by Thorzdad at 7:30 AM on June 23, 2015

Just nthing that everyone - including you - will be colonized with MRSA on and off.

If you have an issue, go to a doctor. It's really got nothing to do with her; you're as likely to get it from a doorknob.
posted by Lyn Never at 8:12 AM on June 23, 2015

I'm not sure that everyone has it anyway, or that we continually gain and lose strains, as has been stated above. That may be true of Staph aureus generally, but MRSA might be different. A recent study(Alam MT, Read TD, Petit RA, et al. Transmission and Microevolution of USA300 MRSA in U.S. Households: Evidence from Whole-Genome Sequencing. mBio. 2015;6(2):e00054-15. doi:10.1128/mBio.00054-15) found that people in households carry isolates that are more similar to each other than to isolates from people outside of the household. That means that transmission is happening within the household more than people are just picking it up in the community. About 11% of the household contacts were colonized with their household member's strain (about 2% of the general public without an infected household member is colonized). So I think you are more likely to be colonized as her partner, but I'm not sure whether it is really a practical problem.
posted by SandiBeech at 12:44 PM on June 23, 2015

I had staph infections three times about six years ago. But my wife never had an infection. I hope that's a good enough anecdote to show you not to worry.
posted by tacodave at 4:42 PM on June 23, 2015

IANYD. I'm actually going to take a different stance than most other folks here, although I agree with most of what they're saying.

Yes, a lot of people out there have MRSA these days, and you may have it already, and everyone has staph and strep on their skin already, and MRSA is just a staph that has to be treated with certain antibiotics. I agree with all that. And if you're a normal healthy person, you probably won't have any issue even if you do get colonized with MRSA. And she has a good chance of not being colonized anymore anyway.

Here's where my point of view differs a bit, though... I have to expose myself to MRSA all the time, because I work in a hospital with sick people. But you presumably don't work in healthcare, and haven't been in jail or rolling around on sweaty gym mats as a hobby, and that means you're actually pretty unlikely to have it already.

So why risk it when MRSA can cause a significant risk of soft tissue infections like abscesses, even in previously healthy people, as well as rarely, more serious infections? (I see MRSA abscesses a lot. They're not life threatening, they're easy to treat, but they hurt and they're nasty!)

It's not like MRSA colonization is incurable. Just have her go through a decolonization regimen! Yeah, it's still possible that you could pick up MRSA somewhere out there in your daily life regardless, but knowing you took whatever measure you could to protect yourself against it in this circumstance ought to help you sleep more soundly.
posted by treehorn+bunny at 1:20 AM on June 25, 2015 [1 favorite]

MRSA can cause a significant risk of soft tissue infections like abscesses, even in previously healthy people, as well as rarely, more serious infections

Is it not true that the non-methicillin-resistant staph strains pose the same risk?

Do you see more MRSA abscesses than those caused by other staph strains?

Or is the issue just that an MRSA abscess is going to take a couple of days longer to clear because the first-line antibiotics would typically have to be seen to be failing before something else gets prescribed?

What I'm looking for here is clarification on the issue of whether MRSA is worth taking more seriously than the general run of staph to the extent that a specific decolonization regimen is actually going to achieve a lasting health improvement for most people. From an ecological standpoint, I would expect any MRSA I pick up to be pretty quickly out-competed by all the other local strains I know I'm being exposed to, and I would also expect this to be the case for most people - with the notable exception of health workers, for many of whom MRSA is their prevalent local strain.

It also seems to me that widespread adoption of pre-emptive anti-MRSA treatment is exactly the kind of thing most likely to give rise to staph strains resistant to the next line of antibiotics. Or am I way off base here?
posted by flabdablet at 8:36 AM on June 25, 2015

Response by poster: FOLLOW-UP: six months later...

We have been dating and sleeping together and I still don't have MRSA! She's pretty rad, so thanks everyone for helping me out. Six months!
posted by special agent conrad uno at 11:25 PM on November 17, 2015 [1 favorite]