Introduction
Every human being carries bacteria. These bacteria are present both in and on our bodies. Staphylococcus aureus is a bacterium that is usually found in the nose and on the skin. 30%-40% of the population carries this bacterium without being bothered by it. These bacteria might cause infections, for instance a boil or a little infected wound. These inflammations usually heal by themselves. In some cases, it may be necessary to treat the inflammation with antibiotics, the medicines that kill bacteria. When Staphylococcus aureus is no longer sensitive to the usual antibiotics, we call it Methicillin-Resistant Staphylococcus aureus (MRSA).
Because MRSA was found on you, you have received this brochure containing information on MRSA and what it means for your admission to the hospital or outpatient care.
What is MRSA?
MRSA is a bacterium that is harmless to healthy people; people don't even notice they are carrying it. In most people, the bacterium disappears within several weeks or months. For people who are ill or people with a weakened immune system, MRSA poses a risk to a (severe) infection. That is why the hospital is attentive to the prevention of the spread of MRSA to other patients.
The Netherlands follows a strict MRSA policy by taking measures in health care concerning suspected and proven MRSA positive patients. MRSA is less common in the Netherlands compared to other countries and, therefore, we stick to this strict policy.
However, occasionally, MRSA also emerges in Dutch health care facilities, for instance because patients have been admitted to a foreign health care facility and have been contaminated there and ‘bring’ MRSA to a Dutch health care facility.
Measures in the hospital
In hospitals, many people come together who are more susceptible to infections due to an illness, treatment or operation. That is why we wish to prevent the spread of MRSA within the hospital and why we are taking additional measures.
Measures during admission to the hospital
Check for being a carrier
On admission, you are checked if you are still a MRSA carrier. A swab is taken from the nose, throat, rectum, and possibly a wound or eczema by using a cotton swab. Sometimes, it is also necessary to examine coughed up mucus (sputum) or urine. These samples are examined in the laboratory for the presence of MRSA. The exam is only reliable when you have not used any antibiotics for 48 hours, so you should always mention any use of antibiotics when a swab sample is taken from you. The physician will inform you of the results after 2-5 days.
Strict isolation
Apart from the check regarding whether you are a carrier, additional preventive measures are taken to prevent the bacteria from spreading to other patients. This is called isolation care. Isolation care includes the following:
- during your admission you will stay in a room alone;
- you will only leave the room in exceptional cases, for instance for an exam that has to be carried out elsewhere in the hospital;
- the staff will follow the gowning procedures that apply within the hospital.
Hospital visits
You may receive visitors. Your visitors have to check in with the nurse in advance. Children will only be admitted in consultation with the nurse and on the condition that they can follow the prescribed rules. The visitors have to follow the hospital's gowning procedure.
After visiting you, your visitors may not visit any other patients in the hospital. Any visits to other patients in the hospital must therefore be concluded before your visitors visit you. This measure too is aimed at preventing the spread of MRSA within the hospital.
Measures during outpatient clinic visits
When visiting the outpatient clinic, additional measures are only taken in case of an invasive procedure, such as an internal examination, wound treatment or an operation. If you come for a check-up or a consultation, no additional measures have to be taken.
Proven carrier MRSA
If the taken swabs show you are MRSA positive, it means you are a carrier of MRSA. The measures mentioned previously in this brochure remain in force. Treatment of MRSA is possible, but it varies from person to person. The type of treatment depends on the place where MRSA was found in or on you. A treatment may consist of the use of a nose ointment and washing with a disinfectant soap. Sometimes, you will be prescribed antibiotics. Your treating specialist and/or GP and a medical microbiologist will assess whether a treatment is possible and/or necessary. Since an MRSA bacterium may also disappear without treatment. In both cases, with or without treatment, there may be a follow-up process during which several series of swabs are taken to assess whether the MRSA has disappeared.
It involves three series with a minimum interval of 7 days.
If all three series are MRSA negative, no isolation measures are applied in case of hospital admission; there will be a check if you are a carrier by means of a series of swabs.
For one year, you will be checked twice if you are still MRSA negative. These checks are carried out by means of swabs:
- on hospital admission
- on an outpatient clinic visit
- at your GP.
After a year, the checks for MRSA will end and you will finally be declared MRSA negative.
MRSA carrier at home
If you receive home care from an institution or home care organisation, the staff will also take steps to prevent spreading the bacteria to other patients, depending on the care they provide. If there is no home care, no measures are necessary. You may receive visitors at home and you may visit other people yourself. Other members of the household who work in health care should inform their employers that they have an MRSA positive household member.
Questions
If you have any questions after reading this brochure, please ask your nurse, treating physician or GP. Or check www.mrsa-net.nl/nl/publiek
You can also contact the department of Infection Prevention of Nij Smellinghe by calling +31 512 588 059. Outside the hospital you can ask for the MRSA / BRMO Noord information point. Call the Netherlands on telephone number 088-2299900. You can also mail to info@MRSA-BRMO-informatie.nl.
For more information you can visit this website: www.rivm.nl/infectieziekten.
Source
Stuurgroep Infectiepreventie Friesland
