This NHS Trust takes the prevention and control of MRSA and healthcare associated infections extremely seriously.
We are committed to reducing infections in our hospitals and continuously giving our patients the best care possible.
What is MRSA?
MRSA (sometimes referred to as a superbug) stands for meticillin resistant Staphylococcus aureus.
About one in three of us carries the bacterium Staphylococcus aureus (SA) on the surface of our skin or in our nose without developing an infection. This is known as being colonised by the bacteria. If SA bacteria get into the body through a break in the skin, they can cause infections such as boils, abscesses or wound infections. If they get into the bloodstream, they can cause more serious infections.
SA infections may require treatment with antibiotics. However, some strains of the SA bacteria are resistant to some of the more commonly used antibiotics. MRSA bacteria are types of SA bacteria that are resistant to the antibiotic Flucloxacillin.
What does it mean?
Most people who have MRSA are referred to as being “colonised”. This means that MRSA is present in the nose or on the skin but doing no harm to the person. People who are colonised will have no signs or symptoms of infection and feel fine. It is not usually necessary to treat MRSA colonisation. However, if you are coming in for surgery to the hospital and found to be colonised, we will arrange treatment for you.
When MRSA causes an infection, this can be mild, eg redness and inflammation around a wound, or it can be more serious, such as septicaemia (infection of the blood). If a patient has an infection caused by MRSA then antibiotics, other than the penicillin class, can be used. These can be given by injection, a drip into a vein or as tablets.
Why do we screen for MRSA?
As we know that some members of the population are carrying this bacterium, we have introduced a screening programme for some of the planned admissions.
As part of the pre-admission process, some patients will be routinely screened for MRSA.
This helps to prevent the spread of the germ to other patients and reduces the risk of complications for you, if you are found to be a carrier.
How will the screening be done?
When your hospital doctor makes the decision for your admission, you will be screened. This will be done by taking swabs from your nose, armpit and groin. A cotton bud will be placed in and moved around your nostrils. This is not painful but may be uncomfortable. Other swabs will be used in your armpit and groin. A sample may also be taken from other areas for example, if you have any wounds or sores. The swabs are then sent to the laboratory for testing.
What happens next?
Only a small proportion of people carry MRSA. If MRSA is not detected from your swabs, you will not be contacted because no further action is necessary.
There is a small chance that the swabs taken may fail to identify the MRSA bacteria even if you are a carrier. This may happen if the number of MRSA bacteria present on your body is very small or if it is present in a body site that has not been swabbed. It is possible that if you are swabbed again in the future, MRSA may be identified.
If the swab shows that MRSA is present, the doctor who requested your screening will arrange for you to receive the treatment.
You may be asked to collect a prescription from your family doctor.
How is MRSA treated?
The treatment consists of an antiseptic body wash daily and an ointment to apply to the inside of your nostrils three times a day. The treatment lasts five days and is called suppression therapy.
The treatment should be started two days before your admission so that day three is the day of your procedure. If you need help to do this, your family doctor can liaise with the community nursing team to support you.
The following suppression therapy is used to reduce the level of MRSA bacteria on your body to protect yourself and other patients when you come into hospital.
- Bactroban nasal ointment (mupirocin 2% 3g tube).
Apply a small amount to the inside of each nostril using a little finger or cotton bud. Squeeze nostrils together to spread ointment throughout the nostrils. Apply three times a day for 5 days.
- Chlorhexidine gluconate 4% antiseptic detergent.
Moisten the skin and apply detergent (approximately 30ml) thoroughly to all areas before rinsing in bath or shower. Use chlorhexidine detergent for all other washing activities (e.g. hand washing) during the 5 day treatment course. Use as a shampoo on days 1 and 2 of the 5 day treatment.
Bed linen and clothing should be changed daily during the suppression therapy.
Please note, this is desirable not essential.
It is important not to start the treatment immediately. Treatment must be started so that the third day of treatment is the day of surgery/admission.
If for any reason you have not been able to commence the treatment two days prior to admission, it will be started on admission to hospital and continued for five days or until you go home whichever is the sooner.
If you have any questions, please ask your health professional.
If you experience an adverse reaction to treatment or need any further advice, please contact Infection Prevention & Control or the Pharmacy department at North Devon District Hospital:
Infection Prevention & Control Department: Tel: 01271 322680
Pharmacy Department: Tel: 01271 322395