Recently you have been admitted to a healthcare facility abroad. This means there is a chance you may carry bacteria with you from that specific healthcare facility, that can be resistant to various antibiotics. These are referred to as MultiDrug Resistant micro Organisms (MDRO) (BRMO in Dutch – “Bijzonder Resistente Micro-Organismen”). The MRSA-bacterium belongs to this group. To this end, additional measures will be taken during your stay in the hospital. This flyer explains why and how these measures are taken.

What is meant by MDRO?

MultiDrug Resistant micro Organisms (MDRO) are bacteria that are resistant to standard antibiotics, meaning that these specific antibiotics will not be able to inhibit or kill the bacteria anymore. Fortunately, healthy individuals will almost never develop symptoms when they carry these bacteria – usually on the skin or in the gut – and will not get sick. However, individuals with compromised immunity have higher chances of developing infections in response to these bacteria. For this reason we want to take appropiate measures in hospitals.

What is special about MDRO?

An infection caused by ‘common’ sensitive bacteria is treatable with standard antibiotics. When MDRO initiate an infection however, the infection will be harder to treat. This is because the prevalent antibiotics will not be able to kill the bacteria anymore. Fortunately, MDRO can still be ceased and killed using other, non-standardized antibiotics. There are a lot of different bacterial species, each with their own name. These names are often abbreviated.

Examples are:

  • ESBL-bacteria (Extended Spectrum Beta-Lactamase)
  • CPE-bacteria (Carbapenemase Producing Enterobacteriaceae)
  • VRE-bacteria (Vancomycin Resistant Enterococcus)
  • MRSA (Methicillin Resistant Staphylococcus Aureus)
  • Other: for example Acinetobacter, Pseudomonas, or Stenothrophomonas.

Measures

To find out whether or not you are carrying an MDRO, some cultures of various places on the body will be taken with a swab. These swabs will be tested in the laboratory to check for possible MDRO. Mostly the results will be in after a couple of days. In some cases (for example in the weekends) it can take longer.

Out of precaution we will treat you as an MDRO-carrier until the results are in. This means that you will be cared for in either contact isolation or strict isolation. The type of isolation depends on the type of ward you are being nursed on. This way we try to prevent the bacteria from spreading within the hospital.

Strict isolation

You will be cared for in a single room that is separated from the hallway by an anteroom. The door towards the anteroom room may not remain opened. Healthcare workers that visit the room will wear a protective apron, a facemask and gloves. If you are transferred to a treatment department, such as an X-ray room or a surgery room, additional measures will be taken there as well.

Contact isolation

You will be cared for in a single room, the door may remain opened. Healthcare workers will wear a protective apron and gloves when nursing you.

If the test results indicate you do not carry the MRSA-bacterium while you are being nursed in strict isolation, the strict isolation measures will be scaled down to contact isolation until the culture results of the remaining MDRO are in. In case you do carry the MRSA-bacterium, you will be nursed in strict isolation throughout your stay.

Visitors

In general, your visitors do not have to take additional measures when entering your isolation room. When it is necessary for visitors to take measures, the nurses will inform them. After leaving your room, your visitors will disinfect their hands with hand sanitizer. Visitors who also want to visit other patients in the hospital, are advised to visit them before visiting you. After visiting you, your visitors will be kindly asked to leave the hospital directly.

Understanding

It is of high importance that MDRO are kept outside of the hospital as much as possible. Therefore we rely on your understanding for following these measures. If you have any additional questions or problems you can contact your physician or the nurse.