MRSA information for patients: What is MRSA?

When a person enters a hospital, they exchange their secure home surroundings for a bed in a small unfamiliar area—the ward. On admission into hospital, the person is potentially put at a disadvantage by their illness, medications, surgery and other treatments as well as the surroundings. By the very nature of its work, a hospital potentially exposes patients to microbiological risks.

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What is staphylococcus aureus?

Staphylococcus aureus is a type of bacteria that can cause a number of common infections. It is found in the nose of 20 – 40% of normal healthy people. It can also be found on the skin, and doesnŐt usually cause harm.

However this germ can cause boils and in certain circumstances, particularly when the skin is broken it can cause infections, which can be treated with a variety of antibiotics. These infections do not normally spread to other people outside of the hospital setting but, as previously mentioned, hospital patients are more vulnerable.

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So what is MRSA

It is short for Methicillin Resistant Staphylococcus Aureus. Methicillin is the antibiotic used in the laboratory, to test whether Staphylococcus aureus is a resistant strain or not.

Flucloxacillin is from the same antibiotic group and the drug prescribed to treat infections caused by Staphylococcus aureus. Over time the germ has adapted itself and become toughened against this group of antibiotics making them ineffective.

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Where did it come from?

MRSA has developed partly through the use and overuse of antibiotics in medicine and agriculture, enabling the germ to become resistant to some of these antibiotics. Also partly because patients are often transferred between hospital wards, allowing the germ to spread. It can also be found in care homes and in the community.

The germ has received a lot of television and press attention. It is often referred to as the hospital superbug.

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Is MRSA dangerous?

MRSA rarely, if ever, presents a danger to the general public. It can be carried by people in the same way as staphylococcus aureus and does not cause different or more serious infections. However, infections with MRSA can be more difficult to treat because there are fewer antibiotics available and generally these have to be given in through a drip into the vein.

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How do you catch MRSA?

MRSA can be picked up by person to person contact with someone who is carrying the germ. Another means of transfer is on the hands of someone who has been tending to a person with MRSA, who hasn’t adequately washed their hands afterwards.

MRSA has also been found (in a small number of research studies) on the clothing of healthcare providers and some equipment. There are procedures that staff undertake to reduce these methods of potential transference. These will be explained later.

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How do you know if you have MRSA?

Often you don’t know unless some swabs are taken. These swabs are rubbed over different areas of the skin and sent to the microbiology lab to be processed.

The nose, throat, armpits, and the creases between your legs and the body (groins) are the usual sites where the swabs are taken from. If there are areas of broken skin, sores or wounds present, these will be swabbed too.

People can have MRSA without showing signs of infection. This is called colonisation. If the person is showing signs of infection, a fever, redness, swelling and discomfort of a wound, as well as having MRSA in that wound, then they are considered to be infected. When someone becomes infected in this way the real problem of MRSA becomes clear. It can be very difficult to treat.

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How is it treated?

If a person is shown to have MRSA colonisation, the treatment consists of daily antiseptic baths and hair washing for a few days, with an antibiotic cream to put in the nose. Sometimes an antiseptic mouthwash is also suggested.

If appropriate more swabs are taken following completion of the treatment to check for ‘clearance’, to see if the germ has gone. Occasionally these treatments can fail to clear the MRSA. Many people will clear themselves spontaneously, however this can take several months.

When an infection is present antibiotic treatment is prescribed. These drugs are given through a drip into the bloodstream and require regular blood tests to observe the amount of drug in the body, to ensure the correct level is achieved. Regrettably there are cases where antibiotics will not be enough. In this instance it is down to the person’s own defence and immune systems, within the body, as to whether the infection can be fought.

Occasionally the body isn’t strong enough, through illness and general weakness, to fight this additional assault on it and some people that are seriously ill can die as a result of their infection.

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Can MRSA be prevented?

There is no vaccine to protect against MRSA.

When a person is suspected to be, or is confirmed as being MRSA positive, they may be nursed in a side room. In areas such as elderly care or in a community hospital this may not be necessary and they will be nursed in a bay with other patients. This is known as barrier or isolation nursing and is undertaken to prevent the spread to other patients. Regardless of whether the patient is in a single room or bay, staff will take precautions such as wearing gloves and plastic aprons when caring for the patient hands–on.

If the patient has a cough that is producing a lot of sputum, the hospital staff will also wear masks as this can spread the germ to others. As well as these protective measures, all staff are taught to wash their hands before and after contact with patients, and take measures to ensure the environment and equipment is kept clean.

Some areas of the hospital are very busy and it is not always possible for staff to wash their hands after seeing every patient. In these situations an alcohol based hand gel is used.

Visitors to all ward areas can also assist us with infection control issues by washing their hands before and after visiting their friends and loved ones. Prevention is better than cure.

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