Multidrug-Resistant Organisms (MDROs)

Closeup of handwashing in sink.

Some bacteria have become resistant to the common medicines (antibiotics) used to treat them. This means the antibiotics can no longer kill those germs. Bacteria that resist treatment with more than one type of antibiotic are called multidrug-resistant organisms (MDROs). MDROs mainly affect people in hospitals and long-term care facilities. But they have also become more widespread among healthy children and adults. A person may be a carrier of the bacteria. Or they may have the infection from the bacteria.

  • Colonization. When a person carries the MDRO bacteria but is healthy, it's called being colonized. This person can spread the MDRO to others. But he or she has no symptoms of infection.                     .

  • Infection. When a person gets sick because of the bacteria, they are infected with the MDRO. This person can also spread the MDRO to others. If not treated correctly, MDRO infections can be very serious and even cause death.

What causes MDROs?

MDROs are mainly caused by the misuse of antibiotics. Misuse occurs when antibiotics:

  • Are taken when they are not needed

  • Are not taken for the full time prescribed by the healthcare provider

  • Are fed in large amounts to animals raised for food, such as chicken and cattle

At first, only a few bacteria may survive treatment with an antibiotic. But the more often antibiotics are used, the more likely it is that resistant bacteria will develop.

Who is at risk for MDROs?

Anyone can be colonized or infected by an MDRO. But certain risk factors make this more likely. These include:

  • Living with or having close contact with a person who is infected or colonized

  • Sharing items with a person who is infected or colonized

  • Having a serious illness or weakened immune system

  • Recent hospital stay

  • Living in a nursing home or long-term care facility

  • Antibiotic treatment

  • Having medical procedures, such as kidney dialysis

  • Having a medical device, such as a tube placed in the bladder to drain urine (urinary catheter)

  • Past MDRO colonization or infection

  • Being older

  • Injection drug use

How are MDROs spread?

  • People who are colonized with an MDRO often carry the germs on the skin and in the body. These people are not sick. But they can spread the MDRO to others.

  • In hospitals and long-term care facilities, MDROs are often spread on the hands of healthcare workers. The germs can also spread on objects such as cart and door handles, and bed rails.

  • Outside healthcare settings, MDRO infections often spread through skin-to-skin contact, shared towels, or sports equipment. Or they spread through close contact with an infected person.

How are MDRO infections diagnosed?

The infected area is swabbed or a tissue sample is taken and sent to the lab. In the lab, the bacteria is identified and tested for resistance to antibiotics.

What types of infections can MDROs cause?

MDROs can cause infections in any part of the body, including:

  • Skin

  • Lungs

  • Urinary tract

  • Bloodstream

  • Wounds

How are MDRO infections treated?

MDRO colonization does not often need treatment. But people are advised to prevent spreading MDRO to others. Depending on the type of MDRO a person has, he or she may have a process called decolonization. Your healthcare provider will let you know more about this treatment if needed.

MDRO infections can be hard to treat. This is because they don’t respond to many common antibiotics. But some antibiotics remain effective against MDRO's and are routinely prescribed. Your healthcare provider will test for the type of MDRO causing the illness and choose the best antibiotic.

Can MDRO infections be prevented?

Hospitals, nursing homes, or long-term care facilities help prevent MDRO infections by doing the following:

  • Handwashing. This is the single most important way to prevent the spread of germs. Healthcare workers should wash their hands with soap and water before and after treating each person. Or they should use an alcohol-based hand cleaner before and after treating each person. They should also clean their hands after touching any surface that may be contaminated, and after taking off protective clothing.

  • Protective clothing. Healthcare workers and visitors wear gloves, a gown, and sometimes a mask when they enter the room of a person with an MDRO. The clothing is removed before leaving the room.

  • Careful use of antibiotics. Use antibiotics only when needed and for the shortest time possible. This helps prevent the growth of more antibiotic-resistant bacteria.

  • Private rooms. People with MDRO infections are placed in private rooms. Or they may share a room with others who have the same germs.

  • Daily cleaning. All patient care items, equipment, and room surfaces are cleaned and disinfected every day.

  • Monitoring. Hospitals closely watch the spread of MDROs. They also educate all staff on the best ways to prevent it.

People in the hospital can help prevent MDRO infections by doing the following:

  • Ask all hospital staff to wash their hands before touching you. Don’t be afraid to speak up.

  • Wash your own hands often with soap and water. Or use an alcohol-based hand gel.

  • Ask that stethoscopes and other tools be wiped with alcohol before they are used on you.

 If you are taking care of someone with an MDRO infection:

  • Clean your hands before and after any contact with the person.

  • Wear gloves if you might touch body fluids. Discard the gloves after wearing them. Then wash your hands well.

  • Wash the person’s bed linens, towels, and clothing in hot water with detergent and liquid bleach.

  • Clean the person’s room often with a household disinfectant. Or make your own cleaner. Do this by adding 1/4 cup liquid bleach to 1 gallon of water.

Everyone can help prevent MDRO infections by doing the following:

  • Wash your hands often with soap and water.

    • Clean the whole hand, under your nails, between your fingers, and up the wrists.

    • Wash for at least 15 to 20 seconds.

    • Rinse. Let the water run down your fingers, not up your wrist.

    • Dry your hands well. Use a paper towel to turn off the faucet and open the door.

  • If soap and water aren't available, use an alcohol-based hand cleaner.

    • Squeeze about a tablespoon of cleaner into the palm of one hand.

    • Rub your hands together briskly. Clean the backs of your hands, the pals, between your fingers, and up the wrists.

    • Rub until the cleaner is gone and your hands are completely dry.

  • Keep cuts and scrapes clean and covered until they heal.

  • Don't have contact with another person's wounds or bandages.

  • Don't share towels, razors, clothing, and sports equipment.

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