Episode Transcript
Infection Control Explained (ICE) Podcast 7 MRSA
This Podcast is brought to you by the GOSH Learning Academy.
[00:00:04] Kate H: Welcome back to the ICE Podcast. ICE stands for Infection Control explained. Today we will be explaining a little bit about what MRSA is. So my name is Kate Harkus, and today I have got Bomi Bang with me. She's one of our infection control nurses in our team at GOSH. Welcome Bomi.
[00:00:26] B: Hello.
[00:00:27] Kate H: Hello. So let's start off by just if you're able to explain a little bit about what MRSA is.
[00:00:37] B: Sure. MRSA is short for Methicillin Resistant Staphylococcus Aureus. So, Staphylococcus Aureus, often called Staph Aureus is a type of bacterium that can live harmlessly on skin or inside the nose of healthy people like yourself and myself.
In fact, studies have shown that about one in three people carry it without even knowing it.
This is called colonisation. There are a few different types of MRSA strains. So most strains of Staph Aureus do not cause problems, and if they do, they can usually be treated easily with standard antibiotics. However, some strains have developed some antibiotics resistance, which means the bacterium has got used to the standard medicines and changed itself so that the medicines do not work as well anymore.
While many bacteria can become resistant to antibiotics, MRSA is one of the best known examples.
[00:01:43] Kate H: Okay, great. That makes sense to me. So thinking about then, if a patient's coming into hospital, what does that mean? If we get a positive test result for MRSA?
[00:01:54] B: So if the test result is positive, it means the person is colonised with MRSA.
A full screening will usually follow with swabs taken from the nose, throat, armpits, hairline, groin, and any broken skins or device sites such as a gastrostomy or tracheostomy. The laboratory then tests the sample to find out which antibiotics would work best in case treatment should be, should become necessary.
MRSA infection is diagnosed if MRSA is grown from samples taken as part of investigating an actual infection such as an infected wound or from a blood sample. If someone shows symptoms of sepsis. If a child is simply colonised with MRSA, they usually will not need treatment, although the the clinical team will consider
each case very carefully and discuss options with yourself. If a child has an MRSA infection, they may need antibiotics. The type of antibiotics will depends on the symptoms and the site of MRSA was found such as blood.
If a child is thought to be a higher risk of infection, treatment to reduce coloniSation may be recommended by the your clinician team.
This usually includes , special antiseptic skin washes and antiseptic nasal ointments. Because both colonised and infected patients can spread, MRSA special precautions will be taken to reduce the risk of passing it on.
So whenever possible, your child will be nursed in a separated room or isolated within a bay.
Also staff will use extra protective equipment such as gloves and aprons, and also an alert will be placed on your child's hospital record to flag the need for these precautions during future appointment. This may mean some appointments are scheduled as specific times, but they will not be canceled, so yeah, you can rest.
[00:04:13] Kate H: Okay.
[00:04:14] B: Yeah, don't worry too much about.
[00:04:16] Kate H: Sure. So obviously we talked about isolating and we've previously talked about on other podcasts as well. So a patient with MRSA then will be needing contact precautions, and could you talk a little about, a little bit about what that would mean for the patient?
[00:04:33] B: Sure. So contact precautions are infection control measures used when germs can spread through touch. So MRSA can be passed on by direct skin contact, usually via the hands or indirectly via contaminated equipment, toys, or surfaces. To prevent this, everyone must clean their hands before entering the cubicle and after leaving the patient's room.
So items living the room are cleaned and disinfected. Also staff wear gowns and gloves in line with the hospital guidelines.
[00:05:12] Kate H: And we still practice gloves off, don't we, even with these patients. So we are still using gloves when they come into contact with blood or bodily fluids. And obviously then we're talking about appropriate hand washing.
And I think it's probably useful to say, we talked about isolating them in cubicles andin a bay even. So it's that. Am I right in thinking by me? It's like hand decontamination as you are leaving wherever that patient is, whether it's a cubicle or an open bed space.
[00:05:42] B: Yeah, absolutely. You're right.
[00:05:44] Kate H: Okay, perfect. So I guess thinking about when a patient is then in hospital and they're trying to visit different places in our hospital. Some patients might visit as an outpatient. For, for example. So is there anything that we need to think about for patients visiting different areas?
[00:06:02] B: Yeah, that's a really good question. If a child comes for an outpatient appointment, the same infection control principles apply, but the measures may be adopted to suit shorter visits. 'cause it's quite different, isn't it? If your patient stay in the inpatient, maybe they stay for couple of nights, whereas an outpatient appointment, this might be just a few minutes.
For example, staff may schedule the appointment at a quieter the time if it's an outpatient appointment, ensure the child is seen in a designated space and where aprons, if close contact is needed. Whereas for inpatient stays, like I mentioned earlier, 'cause they stay longer.
Stricter room based precautions are usually followed.
[00:06:47] Kate H: Okay. I get you.
[00:06:48] B: Yeah.
[00:06:49] Kate H: So thinking about what is actually available, is there things available to patients who can't attend things because of obviously their isolation and having MRSA? So thinking about public areas, weekend clubs, for example, activity type things.
[00:07:08] B: Yes. For children who needs to avoid group activities the hospital team, we have a very dedicated hospital team who can help arrange alternatives.
This might include bedside activities or one-to-one play sessions or resources that's provided by play specialists and volunteers. Your child still has opportunities for fun learning and social interactions.
[00:07:33] Kate H: Okay. That's really good to know. So thinking about, do they need to take any precautions outside of the hospital, like going to school or being at home for example?
[00:07:43] B: It's a very good question. So outside of a hospital, no special measures are usually needed, like I mentioned earlier, it's quite common bacteria that I mentioned earlier, one in three people in general, they carry it without even knowing it. So staff or coronation is very common and children can continue normal activities.
It's a good, everyday hygiene is the most important step, such as washing hands regularly, especially before eating and after using a toilet, etcetera.
[00:08:16] Kate H: Got you. Yep. Makes perfect sense to me. Any other things that we would like to mention before we wrap up, I guess about MRSA? Any other comments?
[00:08:26] B: Yeah.
There's one thing that I would like to emphasise that because MRSA spreads easily between people in hospitals and patients are more at risk of staff, MRSA infections, other hospitals should be informed because of that reason. So if you child is seen at a hospital, other than GOSH, you should let them know that your child has or has had MRSA, the local hospital may employ similar precautions as we just discussed, as we do at GOSH, to pre prevent the spread or bacteria. Should they require further information, they can contact the infection control team at GOSH via switchboard.
[00:09:08] Kate H: Okay. That's really good to know. So we are gonna wrap up now about MRSA and let's think about what are our three key take home messages for any listeners listening about MRSA[KH1.1][KH1.2].
[00:09:30] B: Three key take home messages from me are number one, admission screening for MRSA is really important. Number two basic information. Oh, sorry. Basic infection control practices like cleaning hands and decontaminating equipment you take in and out of a child's room is really important. Lastly, MRSA like any other resistance bugs, can spread easily to others, so please adhere to isolation precautions in place whilst you stay in hospital.
Thank you.
[00:10:07] Kate H: Perfect. Thanks so much Bomi. Join us again for another ICE podcast.
[00:10:14] SA: Thank you for listening to this episode. If you want to find out more about the work of the GOSH Learning Academy, you can find us on social media on Twitter, Instagram, and LinkedIn.
You can also visit our website at www. gosh. nhs. uk and search Learning Academy. We have lots of exciting new podcasts coming soon, so make sure you're subscribed wherever you get your podcasts. We hope you enjoy this episode and we'll see you next time. Goodbye.
