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Infection Prevention and Control

MRSA screening and decolonisation

Information for patients and carers

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Information:

MRSA stands for Methicillin Resistant Staphylococcus Aureus and is a bacterium from the Staphylococcus aureus family.

What is MRSA?

It is a germ that has gained resistance to some antibiotics that are commonly used to treat infection. This means that in some cases it has become more difficult to treat, as not all antibiotics that are commonly used to treat infection work effectively against it.

MRSA like many germs can live harmlessly on the skin or in the nose. We all carry lots of bacteria and it usually doesn’t cause a problem. But when a person comes into hospital carrying MRSA and has a procedure that involves breaking the skin, then the MRSA can get into the body and may cause an infection.

What do we mean by MRSA screening?

All patients (adults and children) admitted to Leeds Teaching Hospitals Trust will be risk assessed and then may have samples (swabs) taken to see whether or not they are carrying the MRSA germ.

Screening means testing to see if you are carrying the MRSA germ.

Many people carry MRSA on their skin or up their nose. If we can find out whether you are carrying MRSA before or when you come into hospital we can use a simple treatment to get rid of as much of it as possible. This is known as MRSA decolonisation and will be explained later. You may be asked to move to a side room during this time.

All adult emergency admissions will have samples taken when they are being admitted to hospital, and some patients who have a planned admission will have theirs taken prior to admission, usually as an outpatient or pre-operative assessment appointment. A small number of children may also require screening.

We can find out if you are carrying MRSA by using a swab. The swab is like a big cotton wool bud. This will not cause you any pain and only takes a few minutes to do. The swabs will be taken from your nose, armpits and your groin area (the inner part of your thigh). Samples may also be taken from any areas of sore or broken skin that you may have or any existing lines, catheters or stoma sites.

The swabs will be tested for MRSA in a laboratory. The results usually take 2 – 3 days, but may be sooner. If screening shows you are not carrying MRSA, you might not hear from the doctor.

What happens next?

The hospital or your doctor will contact you if the screening shows you are carrying MRSA

Important:

PLEASE DO NOT WORRY

If you are told that you are carrying MRSA this does not mean that you are ill. Lots of people carry MRSA on their skin and up their nose. You will be asked to start MRSA decolonisation which is described later.

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What happens if I am an emergency admission?

As it takes a few days to get the result of the MRSA screen test, you will be assessed to see if you have a greater chance of carrying MRSA. If you are assessed as having a greater chance of carrying MRSA you will be started on MRSA decolonisation until the result of the screening test is known. Following further assessment you may also be asked to move into a side room until your results are ready.

MRSA Decolonisation

You will start MRSA decolonisation if your swabs were positive for MRSA or in other situations depending on your risk assessment. Using the MRSA decolonisation means the chances of you getting an MRSA infection or passing MRSA on to another patient are much smaller. (However the most effective way to prevent infections is by frequent hand washing. Please take every opportunity during your hospital stay to wash your hands properly particularly after using the toilet and before eating).

The decolonisation involves washing your skin including your hair with special antiseptic soap and applying cream to both of your nostrils. Your health care professional or doctor will be able to advise you how and when to use the MRSA decolonisation dependent on your circumstances.

Reducing MRSA on your skin before you come into hospital

You will be prescribed the following products to tackle the MRSA germ:

  • A body wash/shampoo that is an antiseptic. It is gentle on the skin and can be used by people with sensitive skin.
  • An ointment, which contains an antibiotic. This is for putting inside your nose (both sides).

The products will depend on your age, known sensitivities or allergies. If you have any questions about your treatment please ask your doctor or nurse.

How to use your nasal cream

MRSA can be found in the nose, so you will need to use your cream for the full period of time it is prescribed. Place a small amount (about the size of a matchstick head) on your little finger or cotton bud and apply to the inside of your nose on both sides. Press both sides of your nose together, this will help spread the cream in your nose properly. Once you have completed this it is important that you wash your hands thoroughly.

How to use your body wash

You will need to wash your body using the antiseptic for the full period of time it is prescribed. Any open or infected wounds that you may have will need to be covered with a waterproof dressing or plaster before you start. The body wash should be used undiluted as a liquid soap. Apply it directly to wet skin with your hands or a cloth. Start with your face and work downwards paying particular attention to the areas around your nose, armpits and groin (See step 1). You should avoid contact with your eyes and ears and do not use antiseptic wash inside the body.

Rinse it off preferably in the bath or by showering (See step 2). After you have given yourself a final rinse dry yourself thoroughly with a clean towel and put on clean clothes.

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Hair

You will need to wash your hair at least twice during the treatment. When using the treatment you should start from the top and work down, so you would wash your hair first then move to the face and rest of the body (Follow steps 1 and 2).

Bed Linen and clothing

We encourage you to change all your sheets, pillow cases and towels at the beginning and end of treatment if you are able to.

Will there be any side effects?

The treatment has few side effects, however if you develop a rash or sore skin please stop the treatment and contact you doctor.

What happens at the end of my decolonisation?

Whilst you are an inpatient and once you have completed your decolonisation you may need to be re-screened. This is to check that you are clear of MRSA (if previously positive) and the decolonisation has worked. This is done by taking three sets of swabs. These are taken in the same way as at admission or in pre-assessment clinic. There needs to be three days in between each set of swabs, so during this time you will need to remain in a side room until we have three negative results. Nursing/ Medical staff will keep you informed of your results on a regular basis. This will not affect your discharge.

Family and friends

While MRSA can be passed from person to person, MRSA is not a risk to healthy people and is unlikely to be a problem in the home or at work. You can still continue with your normal day and social activities. You should use your own towel and not share it with others. Remember to encourage your family and friends to wash their hands frequently.

If you, your family or friends have any problems or questions, please don’t be afraid to contact the Leeds Teaching Hospitals Infection Prevention and Control Team. Their contact number can be found on the back of this leaflet.

Further information

You can find out more about MRSA and the use of your antiseptic pack by contacting the department that supplied it or the hospital Infection Prevention and Control Team.

0113 206 6339.

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  • LN: 002164
  • Edition number: 4 Version 1
  • Developed by: Infection Prevention and Control Team
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