"Were you just labelled as a carrier and treated to eradicate it.? Or are you one of those people who get chronic soft tissue infections from it?"
Since you put it in quotes, which typically indicates skepticism, I'll go into some detail for you. I finished a backpacking trip in 2006 with some nasty infected hairs in my nasal passages and what I thought was shin splints. The shin splints turned out to be cellulitis, though there was no visible break in the skin. The cellulitis was successfully treated with Levaquin. Two weeks later I developed a very painful infection on an index finger in a matter of hours, again with no visible break in the skin. It became so painful during the night that I couldn't sleep.
At this point I checked into an emergency ward. They lanced the lesion, took a sample of pus to be cultured, and sent me home with a prescription for Bactrim. About an hour
after I got home, I noticed red streaks moving up my arm and headed back to the E.R. where they administered an antibiotic parenterally. The test came back positive for MRSA. At that point they swabbed my nose and tested for MRSA. Again, positive. You probably know the drill from this point on, so I won't bore you with the details. Suffice it to say it took several weeks to get me totally clean. In the meantime, I did a lot of research to educate myself on what I was dealing with. It's a nasty bug. My particular strain was resistant to 9 front line antibiotics.
My guess is that I picked it up in Harborview hospital where my Mother spent her last days. They have had a lot of trouble with MRSA there. Another possibility is the gym I work out at. 2 other people acquired it there. It has also occurred to me that I was the vector for bringing it into the gym, but I'll never know for sure. So, yes, MRSA is definitely out there, B.C. One of the lessons I learned is that because it is out there, there is a reasonable chance I have it happily coexisting with various other bacteria, including garden variety staph, on my skin. Based on my experience with the infection, I would be a fool to go far into the mountains without carrying the few items necessary to either prophylactically address the issue by treating any significant wound or, in the event the wound gets infected anyway, to start taking Bactrim and buy myself enough time to get to a hospital. As I said in a previous post, it's only an ounce or so. I can live with that. I dont', BTW, go around slathering Bactroban on every little granite cut or mosquito bite, nor have I ever used the Bactrim. I am aware as anybody of encouraging resistance in bacteria. I also check with my primary doc every year as to whether Bactroban/Bactrim are still effective against MRSA and other staph/strep strains.
I hope this lays your skepticism to rest.
"not because MRSA colonization was doing the worker any harm just living there but because the healthcare worker presumably comes into contact with immunosuppressed people and it was assumed MRSA from the nose of the the healthcare worker might infect this already weakened person."
I would observe that health care workers also go home from work and, if they are carriers, potentially spread MRSA into the larger community. Hand washing alone is not an adequate response, IMO. Studies have been done indicating we put hands to nose dozens of times per day. Every time the hand comes away from the nose, it is a potential vector for spreading it to other parts of the body, or inert surfaces, and thus to other people or pets. I doubt people are going to wash their hands every time they touch their nose. If MRSA is detected in a person, they should be decontaminated to help prevent an already serious problem from becoming astronomically more so. My 2 cents.