Treatment for MRSA and MSSA

Treatment for MRSA and MSSA

You will have been told that you have MSSA or MRSA. These notes answer some
of the questions you may have about what is meant by this, and what will happen to
you now.

WHAT IS IT AND WHAT CAN I DO?
‘MRSA’ meticillin-resistant Staphylococcus aureus and ‘MSSA’ meticillin-sensitive
Staphylococcus aureus are germs that many people may carry on their skin and in
their nose without causing an infection or harm. It is carried more easily on broken
skin, for example where there is a rash, a cut or a sore. Sometimes this can cause
abscesses, boils or wound infections, particularly in people who are already unwell.
It is not related to personal hygiene.

WHERE DID IT COME FROM?
MRSA/MSSA can be part of germs that normally live on the skin. You may have had
it on your skin when you came into hospital or you may have picked it up in hospital.

WHY IS IT IMPORTANT?
Special care is taken with MRSA/MSSA germs when they are found on patients in
hospital, or coming into hospital for operations, because the germs are resistant to
treatment with some antibiotics. If they do cause an infection after an operation, this
may be more difficult to treat.

HOW DOES MRSA/MSSA SPREAD?
MRSA/MSSA may be carried in the nose and other body sites. The germs can
spread easily from one person to another by sticking to the hands or clothes and
then passing to the next person they touch. Because MRSA and MSSA are skin
germs and human beings shed skin scales throughout the day and night,
MRSA/MSSA can also be found in dust. Careful hand washing and good
housekeeping to control dust is important and helps to stop the germ spreading.

HOW CAN I TELL WHO HAS MRSA/MSSA?
Patients with MRSA/MSSA do not look or feel different. We test for it by growing the
germ from swabs taken from skin and wounds.

WILL IT AFFECT ME HAVING MY OPERATION?
If an operation is planned for you and MRSA/MSSA is found on your skin, it is best
to clear the skin of this germ before your operation. This will reduce the risk of a
wound or joint infection. We may need to delay your operation until you are free
from MRSA/MSSA. The decision to go ahead with your operation will be made by
your Consultant.

WHAT WILL HAPPEN TO ME NOW?
MRSA/MSSA can be cleared by using skin treatments. If you have an infection with
the germ, we will also give you antibiotics.

CAN I STAY ON THE SAME WARD? CAN I HAVE VISITORS?
If you are already in hospital, you may be asked to move to a single room while you
are receiving treatment. This makes it more difficult for the germ to pass to other
patients. You may be asked to move to another ward if a single room on your ward
is not available.

You can have visitors as usual. They will be asked to put on an apron and to wash
their hands when visiting you so that they do not spread the germ around. They will
not be ill if they do pick up the germ as long as they are healthy. If in any doubt,
discuss this with the nursing staff.

HOW DOES CARRYING MRSA/MSSA AFFECT MY DAILY LIFE AT HOME?
MRSA/MSSA will not harm your friends and family if they are healthy. There is
normally no need to take special precautions with activities at home.

HOW LONG DOES THE TREATMENT TAKE?
You will be asked to use skin and nose treatment (Staph Pack) for five or ten days.
The treatment is then stopped for two days before we take some more swabs to
check the germs have gone. You may be asked to attend the pre-admission clinic
for this.

If you are in hospital: you will restart the treatment after the swabs for up to five or
ten days, whilst awaiting your results. Sometimes it may take several weeks to
completely clear the germ from your skin. If you are sent home in the meantime, we
will tell you if you need to continue treatment at home.

If you are at home waiting for an operation: you do NOT need to restart any
treatment while waiting for your swab result unless we ask you to do so. Usually you
need three clear sets of swabs before you can have your operation. If your operation
is urgent, we may ask you to use the treatment for five days leading up to your
operation. We may take some swabs after your operation to ensure you are clear of
MSSA/MRSA. Your treatment will be carried out quickly and without affecting your
operation date whenever possible.

WILL IT PREVENT ME LEAVING HOSPITAL?
Unless you have an infection with MRSA/MSSA that requires inpatient treatment,
you will be sent home as usual.

DO I NEED TREATMENT AT HOME?
Not everyone needs treatment at home. We will tell you if you need to continue with
the MRSA/MSSA skin treatment at home. We will also tell your GP and District
Nurse about any treatment needed when you leave hospital.

ABOUT YOUR TREATMENT
You will be given one of three nasal treatments and a skin wash. Each treatment
course is used for five or ten days. The duration depends on which nasal treatment
is best for you. We will tell you which treatment to use and make sure you have the
right medication.

BACTROBAN NASAL OINTMENT
(Mupirocin 2%)
Use this THREE TIMES A DAY for five days. Wash your hands. Put ointment, about
the size of the head of a matchstick, onto your finger and then transfer the ointment
to the inside of one nostril. Repeat for the other nostril. Then press the sides of the
nose together, spreading the ointment throughout the nostrils. Wipe off any excess
with a clean tissue. Wash your hands again.

OCTENISAN NASAL GEL
Use this THREE TIMES A DAY for five days. Wash your hands. Put gel, about the
amount of a pea, onto your finger and then transfer the gel to the inside of one
nostril. Repeat for the other nostril. Then press the sides of the nose together,
spreading the gel throughout the nostrils. Wipe off any excess with a clean tissue.
Wash your hands again.

NASEPTIN NASAL CREAM
(Chlorhexidine 0.1% with neomycin 0.5%)
Use this FOUR TIMES A DAY for ten days. Wash your hands. Put a small amount
of cream, about the size of a pea, onto your finger and then transfer the cream to
the inside of one nostril. Repeat for the other nostril. Then press the sides of the
nose together, spreading the ointment throughout the nostrils. Wipe off any excess
with a clean tissue. Wash your hands again.

ANTISEPTIC SKIN CLEANSER
(e.g. Octenisan®)
This is a hair and body wash which reduces the amount of germs you carry on the
skin. You need to use this for as long as you use the nasal treatment, for five or ten
days. Use it like a shower gel and shampoo. Put 30 ml (about two tablespoons) of
the skin cleanser on a clean wet flannel and wash your whole body vigorously from
head to toe ONCE A DAY for five or ten days. Pay particular attention to the hairline,
skin creases and folds, armpits, navel, groins, creases and folds between the legs
and butt cheeks (perineum) and in between the toes (see picture). Shampoo your
hair on day 2 and 4 of the treatment course.

Leave on the skin for at least one minute then rinse off. Dry skin using a clean towel.

Use a clean flannel and towel for each wash. Put on clean clothing after each wash
and, where possible, change bedsheets at least once during treatment.

Also read the manufacturer’s instructions given to you with your skin treatments,
which may be a leaflet or written on the packaging.

BACTROBAN CREAM (NOT NASAL)
(Mupirocin 2%)
The cream is only used on wounds/lesions infected with MRSA. It is applied ONCE
A DAY under a dressing. We will tell you if you need this cream.

Useful Contact Information
If you have any questions about your treatment, speak to your doctor or nurse. You
can also contact our Infection Control Team at your local hospital:

Worcestershire Royal Hospital	(01905) 763333 ext. 38752
Redditch/Kidderminster Hospitals	(01527) 503030 ext. 44744

If your symptoms or condition worsens, or if you are concerned about anything,
please call your GP, 111, or 999 via the main hospital switchboard for advice.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you
and your loved ones. If you have any questions or concerns, please do speak with a
member of staff on the ward or in the relevant department who will do their best to
answer your questions and reassure you.

Feedback
Feedback is really important and useful to us – it can tell us where we are working well
and where improvements can be made. There are lots of ways you can share your
experience with us including completing our Friends and Family Test – cards are
available and can be posted on all wards, departments and clinics at our hospitals. We
value your comments and feedback and thank you for taking the time to share this with
us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the
nurse in charge or the department manager in the first instance as they are best
placed to answer any questions or resolve concerns quickly. If the relevant member of
staff is unable to help resolve your concern, you can contact the PALS Team. We offer
informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf,
if you feel unable to do so, to resolve your problems and where appropriate refer to
outside help.

If you are still unhappy you can contact the Complaints Department, who can
investigate your concerns. You can make a complaint orally, electronically or in writing
and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: [email protected]

Opening times:
The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please
be aware that you may need to leave a voicemail message, but we aim to return your
call within one working day

If you are unable to understand this leaflet, please communicate with a member of
staff.

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