What are multi-drug resistant organisms (MDRO)?
MDRO are bacteria (or germs) that are resistant to at least three different types of antibiotic. There are many organisms that can become resistant to antibiotics and this information covers common organisms such as Escherichia coli (E. coli), Acinetobacter baumanii, Pseudomonas aeruginosa and other organisms. You may see these organisms referred to as Carbapenemase-producing Enterobacterales (CPE), Extended-spectrum betalactamase producing (ESBL), AmpC beta-lactamase producing (AmpC) or simply MDRO.
Why does resistance to antibiotics matter?
Until now, doctors have relied on certain antibiotics to successfully treat particularly ‘difficult’ infections when other antibiotics have failed to do so. In a hospital, where there are many vulnerable patients, spread of resistant bacteria can cause problems. If the bacteria get into the wrong place, such as the bladder, bloodstream or an open wound they can cause infection that may be difficult to treat.
Does carriage of or infection with a MDRO need to be treated?
If a person is a carrier of a MDRO such as CPE or ESBL, they do not need to be treated. However, if the bacteria have caused an infection then antibiotics will be required as advised by a Consultant Microbiologist.
How might I ‘pick up’ a MDRO?
These bacteria can sometimes be found, living harmlessly, in the gut and on the skin of humans and this is called ‘colonisation’. It can be difficult to say when or where you picked it up. However, there is an increased chance of picking up these bacteria if you have:
- been a patient in a hospital abroad or in a UK hospital that has had patients carrying the bacteria.
- been in close contact with a carrier in hospital or in the community .
- had repeated courses of antibiotics
If any of these apply, you may be at increased risk of being a carrier of a MDRO and it may be recommended that you have some investigations to identify this, if you require admission to hospital.
How will I be cared for while in hospital?
You may be accommodated in a single room with your own bathroom while you are in hospital and on any subsequent admissions. You may be asked to provide a number of samples to send to the laboratory to check if you are carrying a MDRO, or have an infection with the bacteria. These samples may need to be taken more than once. The samples might include swabs e.g. the site any wound you may have, a urine specimen, a rectal swab i.e. a sample taken by inserting a swab briefly just inside your rectum (bottom), and/or a sample of faeces. You may also be tested if you have been in close contact with a patient during your hospital stay who has later been found to have a MDRO e.g. CPE. You will normally be informed of the results within two to three days but none of these measures will hinder your care in any way.
How can the spread of MDRO be prevented?
If a patient in hospital is carrying these bacteria they can get into the ward environment and be passed on by direct contact to another patient. For that reason, you may be accommodated in a single room with your own bathroom to help prevent spread. Healthcare workers must wash and clean their hands regularly. Staff may also use personal protective equipment (PPE) such as gloves and an apron when assisting you.
It is also important for patients to clean their hands regularly too, particularly after using the toilet or before eating or drinking. You should avoid touching your medical devices (if you have any) such as your urinary catheter tube, or any wound you may have. Visitors will be asked to clean their hands on entering and leaving the room and they may be asked to wear gloves and an apron if they are assisting in your care.
Effective environmental cleaning and good hand hygiene by all, staff, patients and visitors, can reduce the risk of spread significantly.
What about when I go home?
While there is a chance that you may still be a carrier when you go home, quite often this will go away with time. No special measures or treatment are required; any infection will have been treated prior to your discharge. You should carry on as normal, maintaining good hand hygiene especially after using the toilet. If you have any concerns, you may wish to contact your GP for advice.
Before you leave hospital, ask the doctor or nurse to give you a letter or card advising that you have had an infection or have been/are colonised with a MDRO and which MDRO you have had. This will be useful for your future care and it is important that you make health and social care staff aware of it, e.g. when attending an outpatient appointment or being visited by the community nursing team. Should you or a member of your household be admitted to hospital, you should let the hospital staff know that you are, or have been a carrier and show them the letter/card.
Patient Advice and Liaison Service (PALS)
If you have some concerns, questions or need advice on our services, you can contact the Patient Advice and Liaison Service (PALS) on 0800 234 6088 or contact The PALS Team.
Feeling low and need someone to talk to?
Call 0800 915 4640
Monday to Friday 7pm to 11pm Saturday to Sunday 12pm toMidnight
Need urgent help?
Call 0800 953 0110 24 hours a day, seven days a week
This leaflet is available in alternative languages and formats upon request. Please speak to a member of our staff to arrange this.