MRSA pneumonia

[strdsbrg]

My 86 year old mother, with modest dementia, broke her hip on 12/11/07.  It was repaired two days later.  She suffered aspiration pneumonia and a UTI fungal infection in the hospital.  She was finally transferred to a rehabiliation center after being in the hospital for 4 weeks.  In the rehab center, they told us she now has MRSA pneumonia.  What are her chances of overcoming all of this?  She is on a trach and at times seems very coherent.  How much longer do we let her endure all of this?  She never says she's in pain or uncomfortable.  Is there a real chance of her surviving it and having a good quality of life?  How do you do discontinue a trach when the patient has coherent moments?  Please respond soon.  I love her so much, but don't know how to deal with this situation.

[oakland1000]

If it is MRSA, then the prognosis does not appear very good.

I just got back from my uncle's funeral.   He was 81 years old and was in perfect shape until early Dec. 07 when his bone adjoining his hip replacement broke.   He had a replacement operation and had to have a second operation 2 weeks later, just before Christmas.   To make a long story short, after weeks of grogginess and a MRSA infection that arose due to the prosthetic parts or the cement, he passed away.   He was on a ventilator and could not breathe on his own without it being extremely labored.  

I am glad your mother is still conscious.   Unfortunately, by the time I went to visit my uncle he was unconscious and I did not get to say my good-byes.   Ask your doctor to give you a truthful assessment of your mother's prognosis.  

For an example of the severity of MRSA see  http://www.journals.uchicago.edu/doi/full/10.1086/313658 , which describes a high mortality for liver transplant patients.

The impression I have is that a large percentage of those infected with MRSA succumb.  
    

[National Jewish Health]

Pneumonia due to methicillin-resistant staphylococcus aureus (MRSA) infection of the lungs can be life-threatening, especially in the elderly, but recovery is possible, especially if your mother has never smoked and heretofore, had healthy lungs.  Assuming that she is receiving intravenous antibiotics, either at the rehab center or the hospital, whether she is to recover or not should soon be evident by clearing or worsening of pneumonia.

You should be in close contact with her doctors, on a daily basis, to discuss the likely scenarios and consider your responses to each.  If her doctors believe that she may yet recover and her appearance to you supports that, then therapeutic efforts should continue.  If she recovers from the MRSA, it is likely that she could experience a quality of life, not dissimilar to that she had prior to the hip fracture, especially if the repaired hip allows her to again to become even semi-ambulatory.

Good luck.