Leaving hospital with MRSA • Patients leaving hospital who are MRSA carriers or who have an MRSA infection, do not need to take the same precautions at home as in hospital.
• They do not pose an increased health risk to other well people in the community, including babies and pregnant women; this is because well people in the community have better resistance to bacteria than ill patients in hospital.
• However, if a relative or carer is helping with dressing a wound, it’s important they wash their hands before and afterwards. Bed linen and clothes can be washed as normal.
For further information The three best sources of information about the current situation are:
NHS Choices Website: www.nhschoices.nhs.uk
The World Health Organisation Website: http://www.who.int
If you would like this information in another format, for example, large print, or audio, or the services of a translator please contact the Infection Control Team on: 0845 155 5000 extension 79716.
MRSA
Publication date: April 2008 Last review date: December 2013 Next review date: December 2015 Leaflet code: UCLH/MB/INF/IC/MRSA/2 Re-order code: UCLH0296
© University College London Hospitals NHS Foundation Trust, Unique Code: 28966
Admission to hospital again When a patient who has previously had an MRSA infection, or was known to carry MRSA is admitted back into hospital, he/she must tell the nursing and medical staff. They may well be screened again for MRSA depending on the length of the intervening period, and precautions will be taken until they are proved to be clear of infection.
Treatment may include: • Giving antibiotics that are active against MRSA if it is causing an infection Sometimes this might mean that you need to stay in hospital longer than planned, particularly if you need antibiotics through a drip.
• Using antibiotic creams and soaps, with the aim of reducing the MRSA carried on the body.
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MRSA—brief facts • MRSA is a bacteria that is not affected by some commonly used antibiotics.
• It can be present in the nose or skin of healthy people without causing a problem.
• MRSA can cause serious infection in sick patients in hospital, if it gets into the body through a cut or wound and into the blood stream.
• It is spread by direct contact with an affected patient or by indirect contact with the bacteria in the environment.
• Spread can be prevented by everyone washing their hands properly, or cleaning hands with alcohol gel and by keeping the hospital clean. Some patients affected by MRSA may also need to be kept apart from other patients to prevent it spreading further.
• MRSA infections can be treated with antibiotics.
About MRSA • We all carry bacteria on our skin and in our noses. This means that we are ‘carriers’ and it doesn’t normally cause any problems. One of the common bacteria that about a quarter of people carry from time to time is called Staphylococcus aureus, often called “staph” for short.
• Occasionally, ‘staph’ on the skin causes minor infections such as boils and infection of cuts. These can be easily treated with antibiotics. Sometimes, however, ‘staph’ cause more serious infections, such as wound infections after surgery.
• Over the last 50 years ‘staph’ bacteria have become resistant to a number of antibiotics, including penicillin and meticillin. This resistance means that the antibiotic will not kill the bacteria. These resistant forms of “staph” bacteria are known as Meticillin-Resistant Staphylococcus aureus or MRSA.
Patients at risk MRSA infections tend to happen in patients in hospital who are already at a higher risk of infection—for example, those on the Intensive Therapy Unit (ITU) or those who have recently had an operation.
Testing for MRSA • Testing (also known as ‘screening’) to see if a patient is carrying MRSA, may be done before he/she comes into hospital. Samples are taken by wiping the inside of the nose with a cotton wool bud. If there are concerns about any wounds, additional samples will be taken.
• The samples are then sent to a laboratory for testing. It may takem up to 24 hours to complete (longer at weekends).
How it spreads • MRSA is spread mostly by direct physical
contact between people. It can also be spread by contact, for example with sheets, towels or dressings from an infected patient.
• Clinical staff have a lot of hand contact with patients and MRSA can be carried on their hands from patient to patient.
Preventing the spread of MRSA If a patient has MRSA, we will take precautions to stop others catching it. • It may be necessary to move the patient into a single room (“isolation”).
• If staff touch the patient or the patients environment they must use disposable aprons and gloves and wash their hands after their removal.
• Staff must wash their hands or use alcohol hand-rub before and after every contact (touch) with the patient.
• Special care will be taken when the patient is moved to another ward, hospital or clinic.
Friends and family visiting a patient who has MRSA are very unlikely to become colonised with MRSA, however you can help prevent spreading MRSA by:
• Washing your hands or using the alcohol hand gel by every bed. Staff, patients and relatives should all wash their hands thoroughly with soap and water or use the alcohol hand rub provided on the ward. This is important before and after any contact with a patient.
• Do not share any personal items, such as towels, face cloths or hairbrushes.
• Any visitor with a severe skin condition or an open wound must be careful when coming into contact with a patient with MRSA. They should tell the ward nursing staff before visiting an infected patient. The ward sister will tell the Infection Control Team who will assess whether precautions need to be taken.
• It is not necessary for visitors or relatives to wear gloves and aprons when visiting patients unless they are visiting a number of different patients in the hospital.