Information for patients and relatives

Transcription

1 Ambulatory Care & Local Networks MRSA Information for patients and relatives This leaflet explains how we treat infections with a bacterium called MRSA (meticillin-resistant Staphylococcus aureus). If you have any questions or concerns, please do not hesitate to speak to the doctors or nurses caring for you. 1

2 What is MRSA? MRSA stands for meticillin-resistant Staphylococcus aureus. Staphylococcus aureus (SA) is a common skin bacterium. It can cause skin infections such as boils and impetigo or infected cuts and grazes. Occasionally, it can lead to more serious infections. MRSA is a type of SA which is resistant to an antibiotic called meticillin and a range of other antibiotics. This does not mean that someone who has an infection caused by MRSA cannot be treated, just that they will have to be given different antibiotics to the ones usually used. Colonisation with MRSA About one in three of us permanently carries SA bacteria in our nose or on the surface of our skin (especially in folds like the armpit or groin) without being aware of it or getting an infection. This is completely normal and is known as being colonised by the bacteria. Another one third of people will carry SA from time to time. In the same way, people can carry MRSA in their nose or on their skin without them being aware of it or having any symptoms. The number of people who are colonised with MRSA is much smaller than the number who carry SA. But people who have recently been in hospital or are admitted frequently are more likely to carry MRSA. Infection with MRSA You usually get an infection caused by SA, including MRSA, when the bacteria get into your body through a break in your skin. Skin infections such as boils, wound infections or impetigo are common. Occasionally, the bacteria can cause more serious infections. For example, they may get into your bloodstream and cause septicaemia (blood poisoning). 2

3 Who is most at risk of an MRSA infection? MRSA does not normally infect healthy people, even if they are colonised. Although it is possible for people outside hospital to become infected, MRSA infections are most common in those who are already in hospital. This is because: they often have an entry point for the bacteria to get into their body, such as a surgical wound or a catheter they tend to be older, sicker and weaker than the general population, which makes them more vulnerable to infection they are surrounded by a large number of other patients and staff, so the bacteria can spread more easily (usually through direct contact with other patients or staff). How will I know if I have MRSA? Almost all NHS patients admitted to hospital are now screened for MRSA. If you are coming in for a planned procedure, you will be screened beforehand by your GP or pre-admission nurse. If you come in as an emergency, we will screen you when you are admitted. We will use swabs cotton buds that are placed on the area we are testing to take samples from your throat, the inside of your nose, your perineum (the skin between your anus and your vagina/ scrotum) or groin, and from any wounds/ breaks in your skin or line or catheter sites. Screening helps us to reduce the chance of patients getting an MRSA infection or passing MRSA on to another patient. What treatment do I need? If you are colonised with MRSA: Your doctor will prescribe a skin lotion for you to wash with as well as an ointment that you need to apply to the inside of your nose. 3

4 How do I use these and when? Skin wash You will be given a bottle of a pink-coloured antiseptic wash called HiBiSCRUB and a small tube of an antibiotic nasal ointment called Bactroban. For five days you must: Use the HiBiSCRUB as a liquid soap/shampoo for a shower, bath or wash every day. Wet your skin and then put undiluted HiBiSCRUB on a clean, damp flannel and thoroughly clean your whole body, working downwards. Pay particular attention to your hair, face, nose, armpits and groin. Avoid getting it in your eyes or your ears. After washing all these important areas, rinse off with clean water. Next, wash your hair with HiBiSCRUB and rinse it off thoroughly. Wash your hair on day one, three and five. Do not share your bottle with other patients. Do not use with it with other shampoos, soaps or moisturisers. Ask us for a new bottle if you run out. Ointment For the five days when you are also using the skin wash you must: Put the antibiotic ointment on the insides of your nostrils three times a day. Making sure your finger is clean, use it to gently press both nostrils together for a few seconds to thoroughly spread the ointment over the inside of your nose. 4

5 Re-swab After five days of using the skin wash and the ointment you will have a two-day break and then be re-swabbed on the third day. This is to see if the MRSA bacteria have gone. The results take several days to come back. If you still have the bacteria on your body you will have to repeat the five-day skin wash and ointment treatment. If you are discharged from hospital before the end of the skin treatment, we will give you a bottle of HiBiSCRUB and a tube of Bactroban to finish the course at home. If you are infected: You will need to follow the skin wash and nose ointment treatment described previously. We will also prescribe you antibiotics. Will colonisation or infection affect my care? If you are colonised or have an MRSA infection, all staff looking after you will wear gloves and an apron to prevent the spread of the bacteria. We may also move you to a side room off the main ward. It will not affect your care in any other way, for example, if you need investigations or a procedure. Do I or my visitors need to take any special precautions? Keep your hands clean and avoid touching any wounds, dressings or drips. All visitors must clean their hands before they enter and leave the ward/room by using soap and water or alcohol hand rub. They do not need to wear gloves or aprons. 5

6 What happens when I get home? As soon as you are well enough you can go home. MRSA will not prevent or delay you from leaving hospital. It should not affect any aspects of your home life, including your usual daily activities. Do I need to tell anyone I have/have had MRSA? We will tell your GP or community nurse, but it is a good idea to remind them the next time you visit the practice. You should always tell anyone caring for you that you have, or have previously had, MRSA. In particular, let them know: when you are admitted to hospital before you are admitted to a nursing or residential home before an outpatient appointment or a visit to your GP Who can I contact with queries and concerns? If you or your carers have any questions about your treatment or any information in this leaflet, please do not hesitate to ask one of the members of the nursing or medical staff on your ward. You can also contact the Infection Control Team at Denmark Hill: Tel: kch-tr.kch-ic-nurses@nhs.uk The Infection Control Team at Princess Royal University and Orpington hospitals, Beckenham Beacon and Queen Mary s Hospital, Sidcup: Tel:

7 Care provided by students We provide clinical training where our students get practical experience by treating patients. Please tell your doctor or nurse if you do not want students to be involved in your care. Your treatment will not be affected by your decision. PALS The Patient Advice and Liaison Service (PALS) is a service that offers support, information and assistance to patients, relatives and visitors. They can also provide help and advice if you have a concern or complaint that staff have not been able to resolve for you. PALS at King s College Hospital, Denmark Hill, London SE5 9RS Tel: Fax: kch-tr.pals@nhs.net You can also contact us by using our online form at PALS at Princess Royal University Hospital, Farnborough Common, Orpington, Kent BR6 8ND Tel: kch-tr.palskent@nhs.net If you would like the information in this leaflet in a different language or format, please contact PALS on Further information NHS Choices Visit the NHS Choices site for more information about MRSA 7

8 Corporate Comms: 0298 PL068.3 December 2013 Review date December 2016