Methicillin-Resistant Staphylococcus Aureus (MRSA): Inpatient Decolonization (N/IICU)

What is methicillin-resistant staphylococcus aureus?

• Staphylococcus aureus is a type of bacteria (germ) normally found on a person's skin and mucous membranes (moist areas of the body, such as inside the mouth). It may cause infections on broken skin or wounds.

• Methicillin is a type of antibiotic that may be used to treat infections caused by Staphylococcus aureus.

• If Staphylococcus aureus does not respond to treatment with this antibiotic, then the bacteria is called MRSA. MRSA can be found in both the hospital and the community.

How is MRSA spread?

• MRSA is spread by direct contact. This means that MRSA on hands of patients, visitors, and staff can be spread to other parts of the body and surfaces we touch, such as chairs, bed rails, toys.

• MRSA is not spread through the air.

• Washing hands before touching a patient in the hospital is the best way to prevent the spread of MRSA.

Who is most at risk for getting MRSA?

Patients most at risk for getting MRSA include patients who:

• Are seriously ill, such as transplant patients or cancer patients.

• Need treatment with multiple antibiotics.

• Have invasive devices, such as central line catheters.

• Have open wounds, such as surgical wounds.

• Require long stays in intensive care units.

• Require long or repeated hospital stays.

What is the difference between colonization and infection?

• When someone has an infection, it means that germs are multiplying and causing symptoms. Usually, the person with an infection feels sick and may have a fever. Antibiotics are often used to help fight infections caused by germs.

• Colonization means that the germs are living somewhere within or on the skin of the body, but are not making the person sick. In most cases, being colonized doesn’t make you sick and no treatment is needed.

• If a patient is at a higher risk of getting an infection in the hospital, there is a benefit to try and decrease the amount of MRSA on the skin and mucous membranes. In these cases, even though it is not an infection, the colonization can be treated with a topical antibiotic.

How is my child being treated for MRSA colonization?

• We will treat your child with mupirocin. This is an antibiotic ointment that is swabbed inside their nose twice a day for 5 days.

• It is not uncommon for recolonization to occur, even if this treatment is successful in the short term.

Why is the hospital concerned about MRSA?

• MRSA can be spread between patients in the hospital unless special precautions are taken.

What type of special precautions will be used to prevent the spread of MRSA?

• There will be a sign on the door of your child’s room to make staff and visitors aware of the high-level contact precautions.

• Staff will wear gowns and gloves when caring for your child. Upon leaving, the staff will remove their gowns and discard them.

• They will remove their gloves and wash their hands or use an alcohol hand rub to clean their hands. Please feel free to remind staff to clean their hands before and after patient contact.

What will happen if my child has to come back to the hospital?

• If your child is readmitted to the hospital, and we cannot prove that they are no longer colonized or infected with MRSA, they will need to be on high-level contact precautions.

Does MRSA ever go away?

• Over time, normal non-resistant germs may take the place of MRSA.

• In some cases, MRSA goes away after treatment and comes back. In other cases, patients remain MRSA colonized.

• Your health care provider will work with staff from the Infection Prevention and Control Department to help decide your child’s MRSA status and whether your child still needs precautions for MRSA.

Who do I talk to if I have more questions?

• Ask your child’s healthcare team.

• If needed, staff from the Infection Prevention and Control Department can help to answer your questions.

 Reviewed July 2024 by Ariana Lowe, RN and Kathleen Gibbs, MD