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Methicillin-resistant staphylococcus aureus

MRSA is a type of bacteria that's resistant to a number of widely used antibiotics. This means MRSA infections can be more difficult to treat than other bacterial infections.

MRSA is a type of bacteria that's resistant to a number of widely used antibiotics. This means MRSA infections can be more difficult to treat than other bacterial infections. 

The full name of MRSA is meticillin-resistant Staphylococcus aureus. You may have heard it called a "superbug".

Staphylococcus aureus (also known as staph) is a common type of bacteria. It's often carried on the skin and inside the nostrils and throat, and can cause mild infections of the skin, such as boils and impetigo.

If the bacteria get into a break in the skin, they can cause life-threatening infections, such as blood poisoning or endocarditis.

Read more about the symptoms of an MRSA infection.

How do you get MRSA?

MRSA bacteria are usually spread through skin-to-skin contact with someone who has an MRSA infection or has the bacteria living on their skin.

The bacteria can also be spread through contact with contaminated objects such towels, sheets, clothes, dressings, surfaces, door handles and floors.

People staying in hospital are most at risk of becoming infected with MRSA because:

  • they're surrounded by a large number of people, which means the bacteria can spread more easily
  • they often have an entry point for the bacteria to get into their body, such as a surgical wound or urinary catheter
  • they may have serious or complex health problems, which makes them more vulnerable to infection

It's also possible to become infected with MRSA outside of hospital, although this is much less common.

Read more about the possible causes of MRSA

Preventing MRSA

In recent years, rates of MRSA have fallen because of increased awareness of the infection by both medical staff and the public. However, MRSA still places a considerable strain on healthcare services.

Some people who need to be admitted to hospital will have MRSA screening beforehand (see below), but there are also some things you can do yourself to reduce your risk of becoming infected. These include:

  • washing your hands frequently – especially after using the toilet, and before and after eating
  • following any advice you're given about wound care and devices that could lead to infection (such as urinary catheters)
  • reporting any unclean toilet or bathroom facilities to staff – don't be afraid to talk to staff if you're concerned about hygiene

If you're visiting someone in hospital, you can reduce the chance of spreading MRSA by cleaning your hands before and after entering the ward. You should also use hand wipes or hand gel before touching the person you're visiting.

Read more about preventing MRSA.

Screening for MRSA

Some patients admitted to hospital for planned or emergency care are screened to see if they carry MRSA on their skin. This helps to reduce the chance of patients developing an MRSA infection or passing an infection on to other patients.

During the screening process, a cotton bud (swab) will be run over your skin, so it can be checked for MRSA bacteria. Swabs may be taken from different places, such as the inside of your nose, your throat, armpit, groin and any areas of damaged or open skin.

If MRSA bacteria are found, treatment with antibacterial bodywash or shampoo and nasal cream to remove the bacteria from your skin will usually need to be carried out before you're admitted.

Read more about MRSA screening.

Treating MRSA infections

Although MRSA infections can be more difficult to treat than other bacterial infections, they're still treatable because the MRSA bacteria aren't resistant to all antibiotics.

Minor skin infections may not always require any treatment, other than draining away any pus from the site of the infection, but in most other cases you'll be treated with antibiotics that MRSA has not yet developed resistance to.

Depending on the severity of your symptoms, antibiotic tablets or injections will be used and you may need to have a combination of antibiotics or take types of antibiotics that are rarely used for less serious infections.

Read more about treating MRSA.

Common questions about MRSA

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Methicillin-resistant staphylococcus aureus

The symptoms of an MRSA infection will depend on what part of the body is infected.

The symptoms of an MRSA infection will depend on what part of the body is infected.

Skin and soft tissue MRSA infections

If MRSA infects the skin, it can result in a wound infection, boil or abscess.

If it infects the deeper layers of skin, it's known as cellulitis.

Typical symptoms are:

  • redness
  • swelling
  • tenderness
  • pain
  • a discharge of pus

Some people have additional symptoms, such as a high temperature (fever) and a general feeling of being unwell. 

These infections can also be caused by bacteria other than MRSA, so having the symptoms above doesn't necessarily mean you have MRSA.

Invasive MRSA infections

If the MRSA bacteria penetrate deeper inside your body or into your blood, they can cause a more serious, invasive infection.

Signs of an invasive infection include:

  • a high temperature of 38C (100.4F) or above
  • chills
  • generally feeling unwell 
  • dizziness
  • confusion
  • muscle aches and pains
  • pain, swelling and tenderness in the affected body part 

Examples of invasive MRSA infections include:

Click on the links above for the specific symptoms of these infections.

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Methicillin-resistant staphylococcus aureus

MRSA is a type of staphylococcal bacteria that has developed resistance to a number of widely used antibiotics.

MRSA is a type of staphylococcal bacteria that has developed resistance to a number of widely used antibiotics.

Staphylococcal ("staph") bacteria are relatively common. About 1 in 3 people carry staph bacteria harmlessly on their skin, usually inside their nose and on the surface of their armpits, groin and buttocks. This is known as being "colonised" by staph bacteria.

Up to 1 in every 30 people are colonised by MRSA bacteria. Like other types of staph bacteria, it's usually harmless and not a cause for concern for most healthy people. However, it can cause problems if it's able to enter the body or it infects someone in poor health.

How MRSA is spread

MRSA bacteria are usually spread through skin-to-skin contact with someone who has an MRSA infection or has the bacteria living on their skin.

The bacteria can also spread through contact with towels, sheets, clothes, dressings or other objects that have been used by a person infected or colonised with MRSA.

MRSA can survive for long periods on objects or surfaces, such as door handles, sinks, floors and cleaning equipment.

MRSA in hospital

You're most at risk of developing an MRSA infection when you're in hospital. This is known as healthcare-associated MRSA infection.

This is because people in hospital:

  • are surrounded by a large number of people, including patients, visitors and staff, which makes it easier for the bacteria to spread
  • often have an entry point for bacteria to get into their body, such as a surgical wound, burn, feeding tube, catheter or intravenous tube
  • tend to have more complex health problems than the general population, which makes them more vulnerable to infection

Who's most at risk?

You may be at an increased risk of developing an MRSA infection in hospital if you have:

  • a serious health condition
  • an open wound, burn or cut in your skin
  • a catheter or an intravenous drip
  • a long-term skin condition, such as a leg ulcer or psoriasis
  • recently had surgery
  • been taking frequent courses of antibiotics that aren't effective against MRSA

Patients treated in intensive care units (ICUs) and surgical wards are at a particularly high risk of developing an infection.

MRSA outside of hospital

Although it's much less common, it's also possible to develop an MRSA infection outside of hospital. This is known as community-associated MRSA infection.

It's generally less serious than healthcare-associated MRSA, and in most cases just affects the skin or soft tissues.

The following factors increase your risk of getting an MRSA infection outside of hospital:

  • living in a crowded environment – such as a military base, prison or student hall of residence
  • frequent skin-to-skin contact – outbreaks of MRSA have been reported in people who play contact sports, such as rugby
  • having a cut or grazed skin – this can allow the bacteria to enter the body
  • sharing contaminated items and surfaces – utensils, tools and surfaces can become contaminated with MRSA, and anyone touching this could pick up the infection
  • poor hygiene – you're more likely to get MRSA if you don't wash your hands regularly and don't clean and cover breaks in your skin

Your GP can carry out a swab to test for MRSA if they suspect it's the cause of your infection.

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Methicillin-resistant staphylococcus aureus

If you have an MRSA infection, you may need treatment with particular antibiotics. If MRSA screening shows that you just carry MRSA on your skin, you'll need decolonisation treatment to remove the bacteria.

If you have an MRSA infection, you may need treatment with particular antibiotics. 

If MRSA screening shows that you just carry MRSA on your skin, you'll need decolonisation treatment to remove the bacteria. 

Decolonisation

Decolonisation involves using antibacterial products, such as a bodywash or powder, to remove the MRSA bacteria from your skin.

An antibacterial cream can be used to remove MRSA from inside your nose, and an antibacterial shampoo can be used to remove it from your scalp.

These products should be used one or more times a day for five days. You do not have to be admitted to hospital for treatment. You can do it at home before you go into hospital.

During the decolonisation process, you should wash every day, ideally using a fresh towel to dry yourself each time. You should also wear a new set of clothes each day and try to change your bedding on a daily basis. The resulting laundry should be washed at a high temperature separately from other people's clothes and bedding.

Treating skin and soft tissue infections

Minor skin and soft tissue infections, such as smaller boils or abscesses, may only require a treatment called incision and drainage.

Incision and drainage involves piercing the tip of the boil or abscess with a sterile needle or scalpel to drain the pus and allow the affected area to heal. Before the procedure, you're likely to be given a local anaesthetic to numb the affected area.

More extensive skin infections, such as cellulitis, will usually require a course of antibiotic tablets.

You're likely to be given a course of antibiotic injections if you develop a skin or soft tissue infection in hospital and you're more vulnerable to the effects of the infection. This might be because you have a serious underlying condition.

Treating invasive infections

If you become infected with MRSA in hospital, it's likely that you'll need to be transferred to an isolation room. This reduces the risk of the bacteria spreading to other patients and infecting them.

You may be placed in a room by yourself or in a small ward with other people who have an MRSA infection. You should still be able to have visitors, but it's very important that they clean their hands thoroughly before and after visiting you and before and after touching you.

For more serious, invasive MSRA infections, treatment will involve a course of antibiotic injections that could last several weeks. A combination of different antibiotics may be used.

Click on the links below for more information on treating some types of invasive infection that can be caused by MRSA:


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Methicillin-resistant staphylococcus aureus

Hospital staff, patients and hospital visitors can take simple hygiene measures to prevent the spread of MRSA and stop infection.

Hospital staff, patients and hospital visitors can take simple hygiene measures to prevent the spread of MRSA and stop infection.

Patients

Most patients who need to be admitted to hospital will have MRSA screening before they're admitted, plus treatment for MRSA to remove any bacteria found on their skin.

This can significantly reduce the risk of becoming infected with MRSA in hospital, but there are still some things you can do to reduce your risk further. These include:  

  • always washing your hands after using the toilet or commode (many hospitals now routinely offer hand wipes)
  • always washing your hands or cleaning them with a hand wipe immediately before and after eating a meal
  • following any advice you're given about wound care and devices that could lead to infection (such as urinary catheters)
  • reporting any unclean toilet or bathroom facilities to staff – don't be afraid to talk to staff if you're concerned about hygiene

If you notice any signs of infection – such as swelling, pus or a high temperature (fever) – after going home, contact the hospital clinic, your GP or NHS 111 for advice.

Read more information and advice about staying in hospital.

Visitors

If you're visiting someone in hospital, you can reduce the chance of spreading MRSA by cleaning your hands before and after entering the ward. You should also use hand wipes or hand gel before touching the person you're visiting.

Hand gel or hand wipe dispensers are often placed by patients' beds and at the entrance to clinical areas.

For more information about visiting someone in hospital, read about NHS hospital services for visitors.

Hospital staff

Hospital staff who come into contact with patients should maintain high standards of hygiene and take extra care when treating patients with MRSA.

  • Staff should thoroughly wash their hands before and after caring for a patient, before and after touching any potentially contaminated equipment or dressings, after bed making and before handling food. 
  • Hands can be washed with soap and water or, if they are not visibly dirty, a fast-acting antiseptic solution like a hand wipe or hand gel.
  • Disposable gloves should be worn when staff have physical contact with open wounds – for example, when changing dressings, handling needles or inserting an intravenous drip. Hands should be washed after gloves are removed.
  • The hospital environment, including floors, toilets and beds, should be kept as clean and dry as possible.
  • Patients with a known or suspected MRSA infection should be isolated.
  • Patients should only be transferred between wards when it is strictly necessary.

These steps aim to reduce the chance of patients infecting themselves and others.

For more information, see MRSA: a guide for nursing staff (PDF, 450kb), by the Royal College of Nursing.

Preventing MRSA outside of hospital

The following advice may reduce your risk of catching or passing on MRSA outside of hospital:

  • Regularly wash your hands and have frequent baths or showers.
  • Keep your fingernails short and clean, because bacteria can grow under long nails.
  • Don't share any products that come into contact with your skin, such as soaps, lotions, creams and cosmetics.
  • Don't share unwashed towels.
  • Don't share any personal items that come into contact with your skin, such as razors, nail files, toothbrushes, combs or hairbrushes, without thoroughly cleaning them first.
  • Keep any cuts, wounds or breaks in your skin clean and covered until they heal

Read more information about preventing germs from spreading and keeping your home clean.

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Methicillin-resistant staphylococcus aureus

MRSA screening is usually carried out on people who need to be admitted to hospital for planned or emergency care. In particular, it's recommended for certain groups at the highest risk of becoming infected with MRSA while they're in hospital.

Who should be screened for MRSA?

MRSA screening is usually carried out in people who need to be admitted to hospital for planned or emergency care.

In particular, it's recommended for certain groups at the highest risk of becoming infected with MRSA while they're in hospital. These include:

  • people who have been infected or colonised (carry the bacteria on their skin) with MRSA previously
  • people being admitted to certain "high-risk" hospital units – including surgery, cancer, kidney and trauma units

People who aren't staying in hospital overnight don't usually need to be routinely screened.

Why am I being screened for MRSA?

Many people carry MRSA on their skin. This is usually harmless, but it can cause problems if the bacteria get into the skin or infect someone in poor health.

People in hospital are particularly at risk of an MRSA infection, because they tend to have complex health problems and are surrounded by a large number of patients, visitors and staff who could spread the infection.

By carrying out a simple test to see if you carry MRSA on your skin, a simple treatment can be given to get rid of as much of the bacteria as possible before you're admitted to hospital, minimising the risk of yourself and others becoming infected.

When and where will I be screened for MRSA?

Usually, you will be screened before you come into hospital for an operation. This may be in a pre-admission assessment clinic, an outpatient clinic or at your GP surgery.

Typically, a nurse will take swabs as part of other checks, such as blood pressure and blood tests, leading up to your hospital stay.

How will I be screened for MRSA?

A nurse will run a cotton bud (swab) over your skin so it can be checked for MRSA bacteria.

Swabs may be taken from different places, such as the inside of your nose, your throat, your armpit, your groin and any areas of damaged or open skin. Swabbing is painless and only takes a few seconds.

When will I get the results from the swabs?

Your swabs will be sent to a laboratory, which will test them for MRSA. The results usually take three to five days, but may come back on the same day.

What happens after I have been screened?

If you are found to be carrying MRSA on your skin or in your nose, you will be contacted by the hospital or your GP. Don't worry if you are contacted. Many people carry MRSA.

Carrying MRSA does not make you ill and you're not usually a risk to healthy people, including healthy older people, pregnant women and children. A doctor or nurse will tell you what to do next.

If you are not carrying MRSA, you're unlikely to be contacted by the hospital or your GP. If you're not contacted, continue with your hospital care as planned.

What happens if I am a carrier of MRSA? 

If you are carrying MRSA on your skin, you may not be able to have your planned operation or procedure straight away. You may need to be treated for MRSA first to protect you and other patients from getting ill.

What treatment is used to get rid of MRSA from my skin?

Your doctor or nurse will discuss treatment with you. It usually involves using an antibacterial wash or powder and a special cream in your nose.

You may be asked to change your clothes, sheets and pillowcases every day, usually for five days.

You don't need to be in hospital while you're using the treatment. Continue until the day of your operation or procedure, or until the five days are complete. You don't usually need to be screened again before you go into hospital.

Read more about treating MRSA.

What if my operation is urgent?

If your operation is urgent and you need to go into hospital quickly, you may be admitted to a side room in the hospital and started on MRSA treatment as soon as possible.

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