What is MRSA?
MRSA is short for Meticillin Resistant Staphylococcus Aureus. It is a type of bacteria that has become resistant to most antibiotics. Approximately 30% of the population carry Staph. Aureus either in their noses, throats or on the skin. This is called colonisation, and is very different from being infected with MRSA. At King’s, we are now screening all patients who come in for elective (planned) operations and procedures.
Read more about the screening process and what happens afterwards.
It is very important to understand the difference between colonisation and infection:
· Colonisation means that the MRSA is carried in the nose, on the skin and possibly in wounds but is causing no harm and producing no symptoms. Staph. Aureus and MRSA are not normally a risk to healthy people
· Infection with MRSA means that the bacteria are causing the person to be ill. It can cause mild infection causing redness and inflammation at a wound site. It can also cause more serious infection, such as bloodstream infections. If a patient has an infection caused by MRSA antibiotics, other than meticillin, can be used. This is given by injection or drip into a vein.
What is the difference between MRSA and “normal” Staph Aureus infections?
The main difference between MRSA and “normal” Staph Aureus is that different antibiotics, such as vancomycin, are used to treat MRSA, and these may not be as effective and can have more side effects. However, there is no evidence that MRSA is more likely to cause an infection than the normal Staph. Aureus.
If a patient is found to have an infection following surgery this is usually caused by the patient’s own bacteria (that is, bacteria they are already carrying at the time of the operation) rather than those present in the hospital environment or on the hands of healthcare workers.
We have found that organisms with resistance to one or more antibiotics are particularly associated with people treated as inpatient in hospitals.
This is usually the result of antibiotics (most of which are needed to treat or prevent other infections) and the transfer of resistant organisms from patient to patient, probably via hands, gloves and equipment or occasionally direct from the environment. We have a number of measures in place which are designed to reduce the spread of MRSA and other infections.
Who is most at risk?
The majority of MRSA appears to occur in patient with what we call risk factors. These include patients who have:
· been admitted to hospital in the recent past
· been in the hospital for a long time
· been receiving antibiotics
· broken skin, for example leg ulcers
· long-term urinary catheters.
How do I know that I have MRSA?
Swabs will have been taken from your throat, the inside of your nose, the groin and sometimes from a wound. These will have shown that you have MRSA.
There are many people in the community who have the MRSA germ without showing any symptoms. By screening we can find out if someone is carrying the germ and provide them with treatment before they are admitted to hospital. We screen all patients admitted for elective (planned) surgery as part of the pre-operative process. This helps to prevent the spread of the germ and lowers the risk of complications occurring because of it whilst you are recovering. The test will either be done in the Pre-Assessment Clinic or before you leave the Outpatient Department. It involves swabs being taken from your throat, the inside of your nose and groin. The tests will not hurt but might feel a little uncomfortable. The swab is then sent to the laboratory for testing. If the swabs are then found to be MRSA positive, you will be given appropriate treatment. More information will be given to you when the test is carried out.
What is King’s doing to control MRSA (and other antibiotic resistant organisms) at the hospital?
King’s has an active Infection Control Team that works closely with the Trust Board, managers and healthcare workers to minimise the infection risk to patients.
All staff joining King’s attend training sessions on infection prevention and control during their induction and regularly while they are working here. Staff also have access to computer-based learning on all aspects of infection prevention and control.
We carry out weekly audits to check that staff are complying with hand hygiene policies, and bright yellow and red signs at the entrances to wards and other clinical areas remind everyone – patients, visitors and staff – to clean their hands.
Information on rates of antibiotic resistant infections in each ward and department is collated regularly, and our staff use this information to help reduce these rates as much as possible.
If a patient who has previously had MRSA or any other antibiotic resistant infection is readmitted to King’s, the Infection Control Team are automatically alerted via our electronic patient record system.
How are we doing so far?
Local surveillance shows that approximately 700 patients from about 60,000 hospital admissions are positive for MRSA each year. This corresponds to about 1% of all patients, and only one third of these will actually have an MRSA infection.
The above rates may be an underestimate as, historically, not all patients were screened for MRSA and a proportion of admissions will actually be the same patients being readmitted (meaning that less than 60,000 different people are admitted) and infections may only be detected when the patient is in the community, but the data is nevertheless useful in monitoring trends.
Recent evidence shows that up to 3% of patients being admitted to King’s are bringing MRSA into the hospital with them from the community.
To reduce the risk to themselves and other patients, all those being admitted electively are being screened on or prior to admission.
Click on this link for more information on screening
This means that the Trust is compliant with the Department of Health requirement to screen all elective admissions by 1 April 2009.
The rate of MRSA bloodstream infections has fallen from 107 in 2003 / 2004 to 38 during the last financial year, a 64% reduction. The Infection Control Team, managers and clinicians are committed to continue to reduce this even further.
Who can I contact with queries and concerns?
If you have any concerns or would like more information, please contact the ward manager for the ward or area you are being treated in, or alternatively contact the infection control nurses on 020 3299 4374 or email ic.nurses@kch.nhs.uk
