What is MRSA?    

There are lots of micro-organisms (germs) on our skin. They are in the air we breathe, the water we drink, and the food we eat. Most of them are harmless, some are beneficial, and a very small proportion can potentially cause harm. Staphylococcus aureus is a common germ that is found on the skin (as a normal skin flora) and in the nostrils of about a third of healthy people. It can cause harm if it enters the body, for example through cuts and sores. Methicillin is a type of penicillin, an antibiotic that is used to treat infections.

MRSA are types of Staphylococcus aureus that have developed resistance to methicillin and some other antibiotics used to treat common infections. Some people carry MRSA on their skin or in their nostrils quite harmlessly. Some people carry MRSA for just a few hours or days, but other people carry MRSA for weeks or months. They may not be aware of being an MRSA carrier because they have no symptoms, and it does not harm them - this is called ‘colonisation’.

MRSA and other germs cause problems in hospitals. Complicated medical treatments, including operations and intravenous lines (drips), provide opportunities for germs to enter the body. MRSA and Staphylococcus aureus can cause local skin infections such as boils and, in more vulnerable patients, they can cause more serious infections in wounds, bones, lungs and bloodstream that will require treatment.

The following make patients vulnerable to infections:

• Their underlying medical condition
• The number of operations they have had
• The presence of open wounds
• How frequently they use antibiotics

What is the difference between colonisation and Infection with MRSA?

MRSA colonisation means that the bacteria is simply sitting on the skin (in any site) but is causing no harm to the person. MRSA infection means the bacteria are causing signs of infection, for example, fever and/or pus discharging from a wound. These patients will usually be given appropriate treatment for the infection.

How do you know if someone has MRSA?

People who carry MRSA do not look or feel different from anyone else. The MRSA does not harm them, and they have no symptoms of infection. When patients come into hospital, a nurse may take swabs for laboratory tests to check for MRSA. In some instances, you may be screened more than once.

Patients who have an infection may develop signs and symptoms, such as a high temperature or a fever. An infected wound may become red and sore and discharge pus. Many different germs can cause these signs and symptoms. Only laboratory tests can show whether MRSA or other germs are the cause of this infection.

How do we care for patients with MRSA?

We take MRSA very seriously, all patients being prepared for or admitted for surgical procedures in ROH are routinely tested by taking swabs from different parts of the patient’s body (mainly from nose, groin, wound or device sites) to check if MRSA is present and to ensure that others are protected from the infection. Patients found to have MRSA are treated and their care discussed to ensure that they can still have surgery or investigations even with MRSA.

MRSA positive patients are usually treated with antiseptic shampoo, body wash and nasal ointment, which reduce or remove MRSA from hair skin, and nostrils - this process is called MRSA decolonisation.

Decolonisation therapy is important before your surgery to reduce the risk of infection. Patients with MRSA will receive the treatment for five days, followed by two days of no treatment before being rescreened to see if the MRSA has been eradicated; this treatment regime will occur over three consecutive weeks until there are three negative results. If the surgery is urgent or cannot be postponed positive patients will be admitted into a side room whilst the decolonisation treatment is completed.

How does MRSA spread?

Carriers of MRSA have it on their hands/skin and they can transfer it to people and objects that they touch. Other people can then pick it up on their hands and pass it on to others.

How to protect yourself / stop the spread of MRSA

Simple hygiene measures reduce the risk of acquiring and spreading MRSA. Use good hand hygiene while you are in hospital. Before and after meals, and after using the toilet or bedpan, wash your hands thoroughly with warm water and soap. Everyone should clean their hands before and after touching patients. Hands can be cleaned with soap and water, or alcohol hand rubs. It’s okay to ask any member of staff if they have washed or decontaminated their hands using alcohol gel or hand washing with soap and water before they commence your treatment, examination, or any form of personal care if you have not seen them do so. Staff will wear gloves and aprons when they care for a patient who has MRSA. Patients who have MRSA may be moved to a room on their own or into a separate area for people who have MRSA.

Do patients have to stay longer in hospital because they have MRSA?

Patients who carry MRSA do not usually have to stay longer in hospital. Patients who have an MRSA infection or any other infection may have to stay in hospital until it shows signs of clearing up. They may stay until they have completed their course of antibiotics, or they may need to continue treatment when they go home. A patient who has MRSA can go home or be cared for safely in a nursing home or residential home, using simple hygiene measures without the risk of it spreading to others in the family or care home. Please try not to worry if you have an MRSA positive test result.

Can MRSA harm friends and family visiting patients in hospital?

MRSA does not usually affect healthy people. It does not usually harm elderly people, pregnant women, children, and babies. But it can affect people who have serious health problems and people who have chronic skin conditions or open wounds. Visitors can reduce the risk of spreading MRSA to other people by:

• Cleaning their hands on arrival and at the end of their visit to the hospital wards using alcohol hand gel or soap and water.
• Not sitting on the patients’ beds
• Taking advice from clinical staff if someone who has a long-term health problem wants to visit a patient who has MRSA or if a patient who has MRSA wants to visit another patient in the hospital.

Can I still go home?

You will not have to stay in hospital any longer than necessary; you will be allowed home when medically fit.

What will happen when I go home?

Not all precautions taken in hospital are necessary at home. However, handwashing is important. It is important when visiting other healthcare environments that you inform them you have had MRSA, so appropriate treatment if required is prescribed.

Further information

If you have further questions, please speak to a member of the ward team or ask them to contact the Infection Prevention and Control team.