MRSA usually lives harmlessly on the skin. However, if the bacteria gets inside the body, it can cause a serious infection that needs immediate treatment. 

An MRSA infection can lead to painful and swollen skin, that feels warm, looks red and leaks pus or liquid. If it spreads, the infection can cause a high temperature, difficulty breathing, chills, dizziness and confusion.

MRSA mainly lives harmlessly on the skin and it usually spreads through touch – i.e. touching someone with MRSA or something they have touched. It will only cause an infection if it spreads inside the body.

In a healthcare setting, some people are more at risk than they would be elsewhere, including those having long stays in hospital (especially those being treated for serious condition) and those with a break or opening in their skin (for example, a drip into a vein, a cut from surgery, a burn or wound, or other skin damage).

It is also a risk for those with a weakened immune system, for example because of a condition like HIV or treatment like chemotherapy. 

Prevention

Because of the reasons listed above, it is important to take every precaution to prevent the spread of MRSA.     
One of the most effective ways of doing this is for everyone to practise good hand washing hygiene. Healthcare organisations should enforce and encourage hand hygiene for staff and patients and provide the facilities to do so. This should include water, soap and hygiene gel.

Patients should be provided with clear information on MRSA screening and decolonisation, in a format and language that they understand.

According to the Healthcare Infection Society (HIS), research shows that patients worry about being infected with MRSA, but at the same time, they do not know enough about it. The Evidence also shows that patients have little understanding of why they need to be screened, isolated or placed under contact precautions.

Awareness

The Society recommends making patients aware of the reasons for MRSA screening and decolonisation and also informing patients of their results as soon as possible. Patients who are identified as MRSA positive should be provided with consistent appropriate information about the difference between colonisation and infection; the microorganism; how 

MRSA is acquired and transmitted; how MRSA is treated; and the reasons for contact precautions or isolation.     
Once discharged patients should also be informed of the risk to household members and the implications for future health and healthcare.

Visitors should also be encouraged to sit on the chairs provided and not the bed of the patient they are visiting.     
Reporting avenues should be easily accessible and well advertised so that patients, visitors and staff can report if an area is visibly dirty and swift action can then be taken.

Screening

Guidelines from the Healthcare Infection Society and the Infection Prevention Society recommend patient screening to minimise transmission. 

Those due to have surgery may be offered a screening test before going into hospital. This usually involves wiping swabs in the nostril, mouth and groin. If the tests come back positive, patients will need to treat the bacteria with a nasal cream or spray, body wash and shampoo.

According to HIS: “Universal screening strategy has no benefit over targeted screening.” However, in some settings, universal screening may be more practical. 

Standard infection control precautions are recommended in the care of all patients and contact precautions should be followed as per the local policy. Shared pieces of equipment should be cleaned and decontaminated after each use.

Healthcare leaders can consider placing MRSA patients in a single room, but according to the guidelines, patients should be isolated for as short a time as possible.

Surveillance should be undertaken routinely, as part of the local IPC strategy and to comply with mandatory national requirements.

Avoid the transfer of MRSA patients between wards and other clinical settings, unless it is clinically necessary. Healthcare leaders should inform the receiving setting and the transport service that the patient is infected with MRSA, so appropriate measures can be taken.

MRSA is a serious problem, so every care should be taken to prevent it. The tips above should help to reduce the spread.