MRSA

MRSA is not a new problem - the strains first appeared in th early 1960's. In some countries where antibotics much more freely than here, the spread MRSA has been accpted as more or less inevitable. In theUK there has been and continues to be a focus on prevention and control.

What is MRSA and what can it do?

Staphylococcus aureus is a bacterium (germ) that is commonly found on the skin or in the nose without causing harm, this is known as colonisation. However, it can sometimes cause abscesses, boils and wound infection, and frequently more serious infections such as septocaemia (blood poisoning), particularly in those who are already unwell.

These infections can usually be effectively treated by commonly prescribed antibiotics. However, some strains of staphylococcus aureus are resistant to an antibiotic called methicillin and some of the antibiotics that are usually used to treat infection. They are referred to as methicillin - resistant staphylococcus aureus (MRSA). MRSA is unlikely to present a problem to a healthy person.

Many people who get MRSA have no symptoms at all, this is known as "colonisation". The germ causing them no harm but still can be spread to more susceptable individuals, particularly in a hospital environment.

Why is MRSA important in hospital?

Patients in hospital can be susceptable to infection because of their illness and/or treatment. If a patient gets an infection caused by MRSA it may be more difficult to treat as the germ is resistant to many, but not all, antibiotics.

This is why hospital staff take infection control measures to prevent the spread of infections including MRSA, in hospitals.

How do you get MRSA?

MRSA may be on someone's skin or in their nose before they go into hospital or they may acquire it during their stay in hospital. The germ can spread from one person to another, most often by hand contact.

This is why good hand hygiene is so important in helping to provent the germ spreading!

Can MRSA be treated?

Once MRSA has been found in one place of the body, staff usually take more samples to see if it is present elsewhere in the body.

If treatment is necessary, it will vary depending on whether or not the patient is colonised or has an infection. If needed, treatment prescribed for colonisationmay consist of to put the noseand an antiseptic skin cleanser/hairwash. In addition the doctor prescribe antibiotic if MRSA is causing an infection.

Each course of treatment usually takes 5-7 days. Once the treatment regime is completed, samples/swabs may be taken again to see if the treatment has been successful in eradicating the infection. These samples will not usually be taken for 48 hours afters completion of a course of treatment. The treatment may need to be repeating. Even if it has been successful it is possible that MRSA can recurwhen someone is vunerable or has been on antibiotics.

Can patients with MRSA have visitors whilst in hospital?

They can have visitors as usual. However, young babies and those who are immunocompromised (people who are more susceptible to infection because of diseases such as cancer, or open wounds, or medication such as steriods) are discouraged from visiting.

Patient or visitors who have any concerns should feel free to discuss them with the nursing ormedical staff, or a member of the infection control team.

It is not generally necessary for visitors to wear plastic aprons or gloves. Hospital staff wear these items as well as washing their hands as part of infection control measures to prevent spread of the germ. However, if visitors are assisting with personal care, it may be prudent for them to wear aprons and gloves. The nursing staff on the ward will be happy to advise.

All visitors will be advised to wash their hands after visiting.

Can MRSA hurt me?

MRSA will not usually harm healthy people. Concerns about MRSA harming family and friends should be discussed with nursing/medical staff.

Will MRSA delay discharge from hospital?

If a patient is medically fit theymay be discharged home or back to a nursing or residential home. Treatment can be completed following discharge.

Will the hospital tell your GP/Nursing home and community nurse about MRSA?

When a patient leaves the hospital, staff will write and if necessary ring the GP or nursing home informing them of the test results and what treatment has already been given or is required to treat the infection. They will also be advised of when, or if any further,swabs/samples need to be repeated.

What special precautions taken in hospital are necessary at home?

If someone in his or her own home has contracted MRSA or a patient is discharged home with MRSA, it is advisable to follow basic hygiene measures including:

- washing hands thoroughly and regularly throughout the day;

- Keeping a bath towel and flannel for personal use;

- Towels, flannels, underwear and bed linen should be changed regulary and laundered using hot of a wash cycle asis compatible with the fabric.

There is no needed to segragate crockery and cutlery. They can be washed in detergent and hot water or in a dishwasher as usual.

Will community nursing/ GP staff take special precautions?

If they are providing personal care they too,like hospital staff, will wear gloves and aprons, as they will be attending to other patients. They will always wash their hands or use a different hand rub before leaving the home.

Do people with MRSA need to stay indoors until the germ has gone?

No - they should lead a normal life doing everything they did before acquiring germ.

What should happen if someone with MRSA is admitted/re-admitted to hospital?

Either the patient, a reletive or carer should tell the hospital staff (medical/nursing) that they have, or have had, MRSA in the past.

Because MRSA can come back, even after treatment appears to have been successful, certain precauttions are necessary. Swabs may need to be taken again and a single room may be necessary until negative sample results are obtained.

It is helpful Accident and Emergency department/ Amittions Office are informed before a bed is allowcated to you in the ward. If a GP is arrangeing the admission it may be helpful to remind him/her about the history of MRSA.

NB. This refers to any hospital and not just the hospital where the MRSA was identified.

Any further should be discussed with hospital nursing/medical staff, the Infection Control Team, community nursing staff or GP, orpublic health (communicale disease) staff as appropriate.

Thanks for reading x