Infection, Prevention and Control - Meticillin Resistant Staphylococcus Aureus (MRSA)

What is MRSA?

There are lots of micro-organisms (germs) on our skin and in the environment around us. Most of them are harmless, some are beneficial and a very small proportion can cause harm.

Staphylococcus aureus is a common germ that is found on the skin and in the nostrils of about a third of healthy people. It can cause harm if it enters the body via cuts and sores.

MRSA stands for Meticillin (M) Resistant (R) Staphylococcus (S) Aureus (A). MRSA are varieties of Staphylococcus aureus that have developed resistance to Meticillin (a type of Penicillin) and some other antibiotics that are used to treat infections.

Some people can carry MRSA on their skin or in their nostrils. They are described as being colonised with MRSA (where the bacteria live harmlessly on the skin). Some people carry MRSA for a few hours or days, while others carry it for weeks or months.

People can be colonised with MRSA but not causing illness and they have no symptoms, unlike people who are infected with MRSA. MRSA can cause harm when it gets an opportunity to enter the body. It can cause simple local infections such as pimples and boils, or more serious problems such as wound infections, chest infections or blood stream infections.

Why is MRSA a concern in hospitals?

MRSA and other germs can cause problems in hospitals. This is because people who are ill are more vulnerable to infections. Complicated medical treatments including operations and intravenous lines (drips) provide opportunities for germs to enter the body. This means extra precautions need to be taken by staff to protect patients from acquiring bacteria such as MRSA. For example, simple hygiene measures, cleaning your hands with soap and water or alcohol hand rub.

How do people get MRSA?

MRSA is usually spread by touch. If a person gets MRSA on their hands, they can pass it to people and things that they touch. It may then be picked up and passed on to others. Sometimes it is very difficult to know where a person has acquired MRSA from because it can also be found in the community as well as in hospitals. However, we do know that it can be acquired by contact with another person with MRSA or their surroundings. This is why the importance of good hand hygiene is emphasised for staff, patients and visitors.

How can you tell if someone has MRSA?

People who are colonised with MRSA do not look or feel different from anyone else and they do not have any symptoms. Patients who have an infection caused by MRSA may have signs and symptoms of infection. They could develop a high temperature, or a fever, or their wound becomes red and sore and discharges pus. Many other germs can cause these signs and symptoms. Laboratory tests are carried out to find out which germs are causing infection.

What precautions are taken to prevent other patients acquiring MRSA?

Patients with MRSA may be moved into their own room, if possible. If there is no side room available, patients can be nursed next to a sink with their own equipment, until a room becomes available.

In order to prevent MRSA from spreading to other patients, staff may wear gloves and apron when caring for people who have MRSA.

We do not ask visitors to wear gloves and aprons when visiting a patient with MRSA unless assisting with direct patient care, but we do ask them to decontaminate their hands with soap and water or alcohol hand rub before and after visiting.

How is MRSA treated?

People who get MRSA can be treated. A nurse may take swabs to check which parts of the body have MRSA. Treatment with antiseptic body wash/shampoo, cream and mouthwash can help to reduce or remove MRSA from hair, skin, throat and nostrils.

If you have a wound infection or infection of any other kind with MRSA, you will also usually be treated with antibiotic therapy.

There is no need to have repeated treatment for MRSA once discharged from hospital. There is also no need for a person with MRSA to avoid contact with other people once they are discharged home.

Can MRSA harm family and friends?

MRSA does not usually harm healthy people, including elderly people, pregnant women, children and babies. MRSA can affect people who have certain long-term health problems, particularly people who have chronic skin conditions or open wounds.

Ask your nurse to contact the Infection Control Team if required for advice if someone who has a long-term health problem wants to visit a patient who has MRSA.

Do patients who get MRSA have to stay longer in hospital?

Patients who carry MRSA do not usually have to stay longer in hospital. Patients who have an MRSA infection may have to stay in hospital until they have completed the course of antibiotics and their infection shows signs of clearing up. Alternatively, they may need to continue treatment when they go home.

A patient who is going to a nursing home or residential home can be cared for safely using simple hygiene measures.

Effective hand hygiene

This is vital in preventing the spread of infections. There are 3 ways to cleanse your hands whilst in hospital:

• Using soap and water at a hand wash basin
• Using the alcohol hand gel which is available throughout the hospital
• Using a hand wipe

Hand Washing

This should always be done after using the toilet, before taking medication, before and after meals:

• Wet hands before applying soap
• Thoroughly lather all hand surfaces, and beneath rings
• Rinse under running water before drying
• Dry hands thoroughly with disposable towels

Using Alcohol Hand gel

Alcohol hand gel is available throughout the Trust as an alternative to hand washing:

• Apply alcohol hand gel to hands and rub over all areas of hands until it has evaporated
• Please note this may affect artificial or varnished nails
• All visitors should use the hand gel on entering and leaving a ward area if access to a hand basin is not available

How can you help?

Patients and visitors can reduce the possibility of spreading MRSA to other people if they support the following:

• Visitors do not sit on the bed
• Visitors clean their hands with the alcohol hand gel or soap and water on entering the ward and at the end of the visit
• If you have MRSA and you want to visit another patient in hospital, you should ask your nurse to contact the Infection Control Nurse if required for advice
• Avoid bringing in too many personal belongings, as this hinders good cleaning practice
• If you are attending a hospital and you have previously had MRSA, please notify a member of the nursing or medical team on arrival
• Please request that any staff who are attending to you (i.e. to check your wound, catheter or IV drip) clean their hands first

For further advice or support, please ask your nurse or doctor to contact a member of the Infection Control Team.

Your information may be shared with the Community Infection Prevention Team. If you have any concerns regarding this, please ask your nurse or doctor to contact a member of the Infection Prevention Team for advice.