MRSA

MRSA stands for Meticillin Resistant Staphylococcus Aureus. Meticillin (previously known as methicillin) is a type of penicillin, an antibiotic used to treat infections. Staphylococcus aureus (Staph. aureus) is a common bacteria (germ) that can be found on the skin and in the nostrils of healthy people. MRSA differs from Staph. aureus in its resistance to common antibiotics, although some antibiotics are still effective against MRSA.

Some people carry MRSA on their skin or in their nostrils, quite harmlessly. They do not know that they carry MRSA because they have no symptoms and it does not harm them. This is called ‘colonisation’ If you are found to be colonised with MRSA, you will be prescribed treatment as necessary to reduce the chance of you developing an infection and to reduce the risk to other patients.

MRSA is a concern in hospital because many patients are vulnerable because they have deep wounds, catheters, drips or drains, which allow the bacteria to enter the body. People with reduced resistance to infection, such as transplant patients, are also vulnerable. For those people infections can be serious.

MRSA behaves in exactly the same way as Staph. aureus, causing the same range of infections. Most people with MIRSA feel normal and have no symptoms at all. MRSA is only detected by a laboratory test.

Swabs and other samples may be sent to the laboratory to see which bacteria grow. A member of your care team will tell you the result.

It is possible to spread MRSA from person to person on contaminated hands (of patients or healthcare workers). As it lives on the skin of humans and in dust, which contains dead skin scales, an accumulation of dust can also help it to spread. Good hand washing by all and ward cleaning can help prevent the spread of MRSA.

In hospital, you will, whenever possible, be nursed in a single room with your own toilet facilities. At home, no special arrangements are necessary.

For nasal colonisation you may be prescribed a cream to apply to the inside of your nose for five days. If you apply your own cream, please ensure that you wash your hands thoroughly after application.

You should wash your body with an antiseptic solution instead of normal soap or shower gel for five days. It should be applied neat (not diluted) to wet skin for a full minute before rinsing thoroughly. Hair should also be washed with the antiseptic solution on day two and day four of your treatment. Normal shampoo may be used after the antiseptic solution.

If your doctor thinks you are showing signs of infection he or she will prescribe a course of antibiotics.

While you are in hospital: 

• staff caring for you will wear personal protective equipment, for example gloves and aprons, to prevent the spread of the bacteria to other patients 
• it is very important that you wash your hands thoroughly with soap and water after visiting the toilet and before eating (staff will help you with this if necessary)
• it is very important that all healthcare staff and your visitors wash their hands with soap and water before entering and leaving your room.

Good hand hygiene by staff, patients and visitors is the single most important measure to reduce the spread of MRSA.

The room will be cleaned daily and the bed linen changed daily.

After MRSA is identified it will be necessary to take swabs from you to find out if you are also colonised in the following sites: nose, perineum/groin and any wounds or skin breaks. Additional sites may be screened if you have drips, drains, catheters etc, and sputum may also be sent for testing.

Results usually take about three days and treatment will begin as soon as the results are known if necessary. After a course of treatment finishes, we will wait two days before re-screening you to see if the treatment was effective. Three sets of negative swabs are necessary before MRSA clearance is given for your current hospital stay.

If basic hygiene measures are followed (thorough hand washing after contact with MRSA and covering cuts or grazes with a waterproof dressing), people with MRSA are not a risk to healthy members of their family or visitors, including babies, children and pregnant women. The general advice for hospital visitors is as follows: • Relatives, friends and other people who are feeling unwell should not visit you.

• Visitors who have had a recent infection or illness should ask the nursing staff on the ward for advice before visiting.
• Children and babies can be more vulnerable to infection. Please ask the nursing staff on the ward or the Infection Prevention and Control team whether visiting is advisable.
• Follow any instructions from nursing staff before visiting.

-Visitors and relatives can still touch you (for example, hold your hands or give you a hug). Your visitors do not have to wear gloves and aprons unless they are helping you with your personal care.

Visitors should avoid sitting or lying on your bed when visiting.

• Visitors must wash their hands well with soap and water before and after visiting to help prevent these bacteria from spreading to other People.

In most cases, MRSA will not delay your discharge home. After going home it may be necessary for you to continue your treatment. If you still have MRSA, thorough hand washing should continue. Keep a towel for your own personal use. A fresh towel should be used after bathing.

Ideally, after bathing, freshly laundered clothes should be worn and your bed linen should be changed every couple of days, if possible.

Your home environment should be cleaned and dusted frequently.

• If you have been discharged from hospital with MRSA it should not affect you or your family and home.
• When you leave hospital your GP will be told if MRSA has been isolated from any swabs or samples taken while you were in hospital.
• Washing your hands is very important to prevent bacteria spreading.You must wash your hands after visiting the toilet and before eating. Any people who are looking after you must also wash their hands with soap and water to prevent spreading the bacteria to other people.

• Staff caring for you may wear gloves and aprons when carrying out certain tasks. This is to prevent the spread of MRSA to other patients they are caring for. Your family members do not have to wear this equipment.
• If you have any invasive medical devices, such as a urinary catheter, you should only touch it if you have been told to clean it. Remember to wash your hands with soap and water before and after cleaning it. We will give you separate information about how to care for it.
• You should make sure your toilets and bathrooms are regularly cleaned with your usual household cleaning products.
• You can continue with leisure and social activities as normal. MRSA should not affect your sex life.
• You should encourage visitors and relatives to wash their hands, using soap and water. Crockery, cutlery and so on can be washed as normal.
• Clothes and bed linen can be washed as normal at the hottest temperature suitable for the fabric. If laundry is soiled, it should be washed separately, preferably at 60°C. If friends or relatives are helping you with your laundry, it is important that they wash their hands with soap and water after handling the dirty laundry.

On each future admission to hospital, swabs will be taken to see if you still have MRSA on your skin.

You will be treated as having MRSA until your swab results are known.

If MRSA is isolated from these swabs, MRSA decolonisation treatment will be prescribed again.

When you leave hospital, your GP (or hospital doctor if you are being transferred) is informed of your MRSA status and any treatment given.

In the following instances, however, staff should be informed that you have MRSA:

• before attending an outpatients appointment or visiting your GP (if he or she is unaware), or dentist;
• before/on admission to a hospital, nursing or residential home.

For more information on MRSA, please speak to the nursing staff on your ward, your doctor or the infection prevention and control nurses.

The Infection Prevention and Control nurses may be contacted by calling Colchester Hospital on 01206 744268 during office hours or Ipswich Hospital on 01473 703742.

Verifying your identity When you attend hospital you will be asked to confirm your first and last names, date of birth, postcode and NHS number, if you know it, and to let us know if you have any allergies.

Please raise any concerns in the ward or department you are in. Ask to speak with the ward sister, matron or department manager. If your concerns cannot be resolved or you wish to make a formal complaint, please call PALS (Patient Advice & Liaison Service) on 0800 783 7328, pick up a PALS leaflet or visit www.esneft.nhs.uk and search for ‘PALS’ Your views If you or a family member has recently been in Colchester Hospital or Ipswich Hospital, you can tell us about your experience by searching for ‘Colchester’ or ‘Ipswich’ on the NHS website (www.nhs.uk), by writing to the address on the front of this leaflet or by filling in a ‘Friends & Family’ questionnaire at the hospital.