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   Hospital eTool - HealthCare Wide Hazards Module
MRO - Multi-Resistant Organisms
  

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Potential Hazard

Exposure of employees to infections from multidrug resistant organisms such as "staph" and "strep" bacteria in the workplace.  Employees can become infected or become carriers and spread infection to other health care workers and patients.

The following information is provided by the CDC.

Multidrug-resistant organisms are bacteria and other microorganisms that have developed resistance to antimicrobial drugs. Common examples of these organisms include:

Staph Bacteria
  • MRSA - Methicillin/oxacillin-resistant Staphylococcus aureus
  • VRE - Vancomycin-resistant enterococci

  • ESBLs - Extended-spectrum beta-lactamases (which are resistant to cephalosporins and monobactams)

  • PRSP - Penicillin-resistant Streptococcus pneumoniae

  • Multi-drug resistant Tuberculosis (MDR) TB is covered in HealthCare Wide Hazards Tuberculosis. 

What is colonization and infection?

  • Colonization means that the organism is present in or on the body but is not causing illness. A hospital employee who has been colonized can become a carrier and spread infection to other health care workers and patients. 

  • Infection means that the organism is present and is causing illness.

Risk factors for increasing the chance of both colonization and infection of these organisms include:

  • Severity of illness

  • Previous exposure to anti-microbial agents

  • Underlying diseases or conditions, particularly:
    • Chronic renal disease
    • Insulin-dependent diabetes mellitus
    • Peripheral vascular disease
    • Dermatitis or skin lesions

  • Invasive procedures, such as:
    • Dialysis
    • Presence of invasive devices
    • Urinary catheterization

  • Repeated contact with the health care system

  • Previous colonization by a multi-drug-resistant organism

  • Advanced age

Possible Solutions

  • The CDC's recommendations for infection control in hospitals consist of Standard Precautions, which should be used for all patient care. In addition, the CDC recommends Contact Precautions in special cases, when the facility (based on national or local regulations) deems the multidrug-resistant microorganism to be of special clinical and epidemiolgic significance. For more information about the CDC's standard precautions:

Additional Information

Multi-Resistant Staph Aureus (MRSA)

MRSA has been identified as a nosocomial pathogen (i.e., hospital-acquired pathogen, as well as a community-acquired organism).

Potential Hazard

Staphylococcus aureas or Staph aureus or just plain staph is a bacteria found on everyone's skin that occasionally causes infection.

When staph bacteria become resistant to methicillin (a simple type of penicillin), they are known as MRSA. This does not mean those particular staph are any more likely to cause infection; it just means if they do cause infection, they will be much harder to kill. It is also a warning signal about the overusing antibiotics. Infections with MRSA are now primarily treated with one antibiotic called vancomycin. If the MRSA bacteria become resistant to vancomycin, we will be left with little to treat it.

Significant problems can be caused by MRSA infections in people with immune deficiency problems, the elderly, or those who have just had surgery and have skin that is open and healing. 

Hospital employees exposed to MRSA and other infections can become infected or become carriers and spread infection to other health care workers and patients. 

Possible Solutions

  • Practice Universal Precautions to help protect employees from infection.

  • The CDC's recommendations for preventing transmission of MRSA in hospitals consist of Standard Precautions, which should be used for all patient care. In addition, the CDC recommends Contact Precautions in special cases, when the facility (based on national or local regulations) deems the multidrug-resistant microorganism to be of special clinical and epidemiolgic significance. For more information about the CDC's standard precautions:

     

  • Hospitals in different geographical locations will need to establish their own local MRSA data and provide treatment information to clinicians.

  • Vancomycin is recommended for use as initial empiric therapy for suspected staphylococcal infection for health care workers exposed to MRSA.

Additional Information


 

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