Today many hospitals in Canada and around the world are dealing with bacteria which no longer respond to many, or all, antibiotics. Thunder Bay Regional Health Sciences Centre is taking steps to prevent and control the spread of antibiotic resistant bacteria. These bacteria do not cause problems in healthy people, but they can cause infections in people who have weakened immune systems or who have had major surgery. The following material explains what these bacteria are and what we are doing to control their spread.

What are antibiotic-resistants?

VRE (Vancomycin-resistant enterococci) is a form of common bacteria (enterococci) which usually lives harmlessly in our intestines and genital tract. VRE is resistant to all currently-approved antibiotics.

MRSA (Methicillin - resistant staph aureus) is a form of another common bacteria (staph aureus) which lives on our skin and in our noses. MRSA is resistant to many antibiotics.

Who is at Risk of Carrying the Resistant Forms of VRE & MRSA?

1. Patients who have been hospitalized overnight within the past 6 months in a hospital, long term care or chronic care facility may have contracted one of these bacteria and may not know it.
    
2. Patients in contact with other patients (roommates) who have VRE or MRSA.

What steps are being taken to control the spread?

As these resistant bacteria can spread quickly through a hospital steps are taken to identify and protect patients.

1. If a patient has been hospitalized overnight within the past 6 months in a hospital, long term care, or chronic care facility, nursing staff will obtain a nasal and rectal swab from the patient. (a cotton - tipped swab, like a large Q-tip will be touched just inside each nostril for the nasal swab,and a second swab will be touched to the skin around the rectal area.) In addition, patients who have been in a facility outside Canada in the past 6 months will be moved to a private room and precautions (see #2) will be taken until results of swabs are known (2-6 days).
    
2. If VRE or MRSA is detected, or suspected the patient and his/her roommates will be placed into separate private rooms. All people entering the rooms will be required to wear gowns and gloves, and to wash their hands or use hand sanitizer when leaving the room. The roommates will also be tested for the bacteria with rectal and/or nasal swabs.
    
3. Other patients on the unit may be tested and any other patients found to be positive will have the same precautions taken.
    
4. Patients who are positive will remain in private rooms with special precautions, at least until they have 3 negative tests 5-7 days apart.
    
5. Patients who have VRE or MRSA can be discharged from hospital as soon as their conditions allows. These bacteria are of little concern for others living in the home or for the patient once healthy.

How do Bacteria Spread?

V R E can spread through person to person contact and on the hands of caregivers. It can also spread on objects such as thermometers, blood pressure equipment, & room furniture. It can live on some surfaces for hours or weeks.

M R S A is spread mostly though person to person contact, and on the hands of caregivers. It is not easily spread through contact with objects in the environment. V R E & M R S A do not spread though the air!

Good handwashing or use of hand sanitizer is the best way to prevent the spread of these and other bacteria.

What if I have VRE & MRSA?

Both V R E & M R S A can live harmlessly on, or in, the body without causing any illness or symptoms. They can, however, cause infections if they get into the blood, urinary bladder, lungs or open wounds. If an infection develops with one of these bacteria your doctor will decide what is the best course of treatment. There are a few antibiotics available to treat MRSA and VRE.

By taking steps now to control the spread of these bacteria we can help prevent a small problem from becoming a big problem later on.

If you have any questions please ask your doctor or nurse.

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