MRSA

MRSA stands for methicillin resistant staphylococcus aureus. MRSA is an infection caused by a group of bacteria called staphylococcus aureus. There are many different types of staphylococcus aureus. These bacteria are usually found on the skin and are often responsible for pimples and boils.

MRSA is a particular type (strain) of staphylococcus aureus that does not respond to many commonly used antibiotics. This means they are resistant to many antibiotics. These antibiotics include a type of penicillin called methicillin. You might have heard MRSA called a superbug.

MRSA was first seen in several countries in the 1960s. With the increasing use of antibiotics, new strains of MRSA have developed.

To try and reduce this resistance the Department of Health has produced guidance to GPs and the public. This is to promote more careful use of antibiotics. Hospitals have their own antibiotic policies, which follow national guidance.

Difference between carrying MRSA and having an infection

About a third of people carry MRSA on their skin or in their nose without knowing it. They are carriers of MRSA but the bacteria doesn't usually cause any harm. Most people who carry MRSA in this way don’t go on to develop an infection.

You get an MRSA infection when the bacteria get into your body tissues or bloodstream and multiply. They can get in through a break in the skin, such as a wound or drip site, or by travelling up a tube (catheter) into the bladder. 

MRSA infections mostly affect people who:

• are in hospital for long periods of time or other healthcare settings such as care homes
• have had surgery
• are seriously ill in intensive care
• have a weak immune system and are at risk from infection

How do bacteria become resistant to antibiotics?

These new resistant strains develop because some bacteria may not be destroyed by a course of antibiotics. They have particular characteristics that protect them from the antibiotic. The bacteria then grow and divide in the body to produce a strain that is resistant to antibiotics.

It is more likely that bacteria will adapt to antibiotics and become resistant if:

• they are used too often
• the dose is not high enough to treat the infection
• antibiotics are prescribed when they are not needed

How does MRSA spread?

Because staphylococcus aureus bacteria live on the skin they are easily spread by direct contact, often from people’s hands.

MRSA also spreads on bedding, towels, clothing, and equipment. This is why strict hygiene and hand washing measures in hospitals are so important.

Symptoms

The symptoms of an infection with MRSA depend on the part of the body that is infected.

Common sites where MRSA infections can develop include:

• broken skin
• the bloodstream (bacteraemia and sepsis)
• joints of the bones
• the lungs (pneumonia)
• heart (endocarditis)
• urine (wee) infections

There are several symptoms you might have when you have an infection:

• pain, redness, discharge, swelling or heat at the site of a wound or intravenous line such as a central line or PICC line
• wounds that are slow to heal
• skin changes - redness, feeling hot, swelling or pain
• boils or abscesses (pus filled areas)
• a change in your temperature - 37.5°C or higher or below 36°C
• flu-like symptoms - feeling cold and shivery, headaches, and aching muscles
• pain having a wee, going more often, cloudy or foul-smelling wee
• pain anywhere in your body that was not there before your treatment
• a fast heartbeat
• being sick (vomiting)
• a headache

An infection can develop into a more serious condition called sepsis which can be life threatening. Call 999 or go to your local Accident and Emergency (A&E) immediately if you have any of the following:

• slurred speech or confusion
• extreme shivering or muscle pain
• passing no urine (in a day)
• severe breathlessness
• skin mottled or discoloured

Screening and testing for MRSA

Depending on what treatment you're having and whether you are staying in hospital you might have screening for MRSA. You have a series of swabs taken from your:

• nose
• throat
• skin - this might include your armpits, groin area, and any cuts or broken skin

The results are usually available within a few days. If you're not carrying MRSA you have your treatment as normal. If you are carrying it the doctor will contact you and you will have treatment to get rid of it. 

If your doctor thinks you might have an infection you need to have tests or swabs to find out. You might have a:

• blood sample
• urine sample
• swab from a wound or drip site
• sputum sample

The samples go to the lab to find out what the infection is and which antibiotics it is sensitive to.

Treatment for MRSA

MRSA infections are still often treatable with antibiotics. Your doctor will need to prescribe particular types because many standard antibiotics don’t work.

For a mild infection, you can have antibiotic tablets. If the infection is more severe you may have antibiotics in hospital. You might have them as an injection or through a vein in your arm (intravenously). The antibiotic vancomycin is commonly used for MRSA. 

Your doctor, nurse, or pharmacist will explain what antibiotics you need and how you have them. They will also explain the possible side effects. 

If you carry MRSA, you may need treatment to clear it from your body. This reduces your risk of getting an MRSA infection in the future and helps limit its spread to other people.

MRSA can sometimes be difficult to get rid of completely. You may have antibiotic cream for your nose, and special soaps, powders, and shampoo for the rest of your body.

Controlling the spread of MRSA

Hospital staff are working hard to control the spread of MRSA by:

• making sure they wash their hands and use alcohol hand gel between patients
• screening patients for MRSA when they are admitted to hospital
• using antibiotics carefully in line with guidelines
• improving ward cleaning and inspection
• looking after people with MRSA in single rooms until their infection has cleared
• having a policy on how to manage MRSA

Helping yourself

If you’re in hospital and are worried about getting MRSA there are some measures you can take yourself.

Tips

• Keep your hands and body as clean as possible.
• Don’t share soap or towels.
• Always wash your hands after using the toilet, before meals, and when you enter or leave a ward or department.
• Make sure your bed area and bedding are cleaned regularly - don’t be afraid to report poor cleaning to the nurses.
• Tell the ward manager if you see any staff forget to wash their hands.
• Take antibiotics as instructed and always finish the course.
• Keep cuts and wounds clean and covered.