What is MRSA?
Staphylococcus aureus is a bacterium that is found in about 30% of the population and is generally harmless. However it can cause infection if it enters a wound or cut. The infection can range from a mild spot to a serious blood poisoning or pneumonia.   Staphylococcus aureus that are resistant to the antibiotic Meticillin is termed MRSA.

MRSA can be present (or colonised) in the nose, throat or perineum (groin). It does not pose a risk unless it is transported to a wound or in those weakened by current illness.

1. MRSA patient information leaflet
2. www.hpa.org.uk

MRSA is usually spread by the hands, equipment and sometimes the environment. Patients should be nursed in a single room and enhanced environmental cleaning performed.  All visitors and staff are advised to clean their hands before and after visiting patients with the alcohol hand rub  available at every bed space.

A key strategy in controlling Meticillin-Resistant Staphylococcus. aureus (MRSA) is to screen patients, instigate contact precautions and prescribe eradication therapy. Plymouth Hospitals NHS Trust has been an early leader in this field for a number of years with screening being performed under the following circumstances:

• All planned surgery admissions
• All patients over 60 years admitted as a medical or surgical emergency
• All patients admitted to the Critical Care and High Dependency Units
• All patients admitted to the Renal, Haematology and Oncology wards
• All Haemodialysis patients
• Any patient not covered by the above and who:
  - Is admitted and known to have previously been colonised (these are identifiable by a Clinical Alert on their clinical notes)
  
  - Is resident within the last six months in long stay healthcare facilities including other hospitals and nursing homes. This includes direct admissions from other hospitals or nursing/ residential homes
  
  - Is a newly identified case of MRSA in order to determine the extent of colonisation
  
  - Has been colonised and received a round of eradication therapy

From April 2009, these circumstances were extended to include all planned procedures and the next stage in the MRSA screening programme will be to include all emergency admissions by 2001 as directed by the Department of Health.

What are we doing to protect you?
Patients admitted to PHNT who are known to be colonised with MRSA are identified by an alert on their electronic record and in their clinical notes. These patients, as well as all newly identified inpatient with MRSA, are visited by the Infection Control Nurse who instigate appropriate infection control measures and prescribe an antiseptic body wash which is used as a soap/shampoo substitute and an antibiotic nasal ointment. The patient colonised or infected with MRSA should be nursed in a single room until their current MRSA status is known. Patients currently or previously known to be colonised with MRSA will be prescribed appropriate antibiotic therapy to reduce the risk of developing an infection.

MRSA Rates at Plymouth Hospitals NHS Trust
All Trusts are required to investigate and report all MRSA bacteraemias (bloodstream) infections to the Department of Health surveillance programme.

Between April 2008 and March 2009 PHNT reported a total of 28 MRSA bacteraemias, 11 fewer than the target of 39 cases.  There has been a year on year reduction and is the lowest number recorded by the Trust and this represents a 71% reduction against the target set by the Department of Health.

Root Cause Analysis (RCA) is carried out on all MRSA bacteraemias at PHNT and is performed by the clinical teams caring for the patient with the support from the Infection Prevention and Control Team. The results of these RCA’s are reported to the Infection Prevention Board and a series of recommendations made. Monitoring of actions arising from the RCA’s is also monitored by the Infection Prevention Board chaired by the Chief Executive

2. MRSA Monthly Chart
3. MRSA Yearly Chart

 

1. To view the Chief Executive's statement about MRSA screening click this link
2. To view the protocol for screening of elective patients for MRSA click this link
3. To view the protocol for elective pre-operative screening of vascular graft patients for MRSA click this link
4. To view the protocol for elective pre-operative screening of orthopaedic joint replacement patients for MRSA click this link
5. To view the Management & Control of Meticillin-Resistant Staphylococcus Aureus policy click this link