MRSA-bacterium infection

What is MRSA?
MRSA, also known as “the hospital acquired infection”, is the abbreviation for Methicillin Resistant Staphylococcus aureus. That means a Staphylococcus aureus (bacterial) infection that cannot be treated with the antibiotic flucloxacillin (= methicillin).
Approximately 30 % of the population carry the Staphylococcus aureus bacteria and in some cases this can cause infections. Flucloxacillin is an antibiotic that is used in almost all cases to treat a staphylococcus infection. In approximately 1 % of cases the staphylococcus is not sensitive to this medicine and other related medicines. This figure applies to the Netherlands. In almost all other countries this percentage is much higher (> 30 %). In a foreign country a Staphylococcus aureus infection cannot be treated with the standard, cheaper medicines. They have to resort to using medicines with many more side effects and that can only be administered via an infusion in the hospital. These medicines are also more expensive than those used in the Netherlands. The Staphylococcus tends to transfer easily from one person to another, especially people with a weakened immune system and in places where people receive more intensive care such as care institutions. Certain occupational groups (including pig farmers and veal farmers) in the Netherlands have a higher risk of being an MRSA carrier.

Why take measures to combat MRSA?
In the Netherlands we are in the fortunate situation that we are still able to use the cheaper medicines. This is due to a conservative policy on the use of antibiotics not seen in other countries. Therefore, a national agreement has been reached that everything must be done to maintain this situation. The aim is active prevention of this bacterial infection and treatment if the bacteria is found to be present. We call this the Search and Destroy Policy.

What are the consequences of MRSA infection?
Generally, an MRSA carrier will not become ill. Infection with this bacteria occurs when resistance is decreased. These infections are then difficult to treat. The bacteria can also be passed on to other people, who in turn will not become ill if they have a normal immune system. People with a normal immune system do not easily pick up this bacteria and most of them are able to get rid of the it by themselves within several months. However, in some cases this does not happen and special precautions are essential.

How is the Search and Destroy policy implemented?
As the risk of acquiring an MRSA bacteria is greatest in foreign hospitals, all people who have been admitted or treated in a foreign hospital are requested to report this when seeking treatment in a Dutch hospital. A number of cultures will be taken to check for the presence of MRSA. These cultures are taken from sites where the bacteria is most found in people. These sites are in the nose, in the throat and on the perineum (area of skin between the anus and the external sex organs) and at all sites where an infection might be / is present. The result is known after about 3 - 5 days. If the result is negative (you do not have MRSA) there is no further problem. If the result is positive (you do carry the MRSA bacteria) new cultures will be taken and a treatment plan will be drawn up. After the treatment you will be monitored on several occasions for the presence of MRSA. Until you test negative, the hospital where you are being treated will implement protective measures to prevent transmission. You will be admitted in an isolation room and the people entering your room will wear special gowns, gloves and a facemask. The number of examinations will also be limited to the most essential. Any procedures that are not urgent will be postponed. This also applies to surgery.
Of course all medically essential treatment will take place; the standard of care cannot be affected. In some cases the bacteria will still spread through the hospital and far-reaching measures will be implemented to prevent and limit the further spread.
Once you are no longer infected with MRSA (three consecutive negative cultures over several weeks), the isolation will be suspended. You will still be monitored at each hospital visit for a year after treatment. After one year you will be definitively cleared.

Finally

If you have questions, please ask your treating doctor and the nursing staff. If necessary, they will contact the Infection Prevention department to seek answers to the questions.

Edition: June 2009/