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Multi-drug resistant organism admission screening

Published on 15 December 2023

Screening policies

Patient screening for multi-drug resistant organisms (MDRO) on admission to hospital is key to reducing the development and spread of infections in healthcare. Early detection of high-risk patients – using a clinical risk assessment (CRA) based approach – allows early isolation while microbiological samples are tested. This reduces the opportunity for transmission if a patient is colonised or infected.

Scotland has two national acute hospital admission MDRO screening policies:

  • meticillin resistant Staphylococcus aureus (MRSA) screening
  • carbapenemase-producing Enterobacteriaceae (CPE) screening.  

MRSA screening programme

Staphylococcus aureus is a bacterium that colonises human skin and mucosa. Most strains of S. aureus are treated with commonly used antibiotics. However, some S. aureus bacteria are resistant to several widely used antibiotics and these are called MRSA.

Normally the bacteria don't cause harm and those colonised with S. aureus have no symptoms. But, S. aureus can lead to serious infections when bacteria spread to the bloodstream. This may occur when the skin's broken, particularly following surgery or a medical procedure. Examples of the types of infections include:

  • skin
  • wound
  • infected eczema
  • abscesses
  • joint
  • endocarditis
  • pneumonia
  • osteomyelitis
  • urinary tract
  • bacteraemia.

Read our Protocol for CRA MRSA Screening National Rollout in Scotland document for more information on:

  • who gets tests for MRSA on admission to hospital
  • the questions patients are asked during the risk assessment
  • how samples are taken for testing
  • the body wash and nasal treatments MRSA carriers are given

Our patient information leaflets give further advice about MRSA screening clinical risk assessment for individuals.

CPE screening programme

Enterobacteriaceae are part of the normal range of bacteria found in the gut. CPE are a type of this bacterial group, which are resistant to carbapenem antibiotics. They carry a gene for a carbapenemase enzyme that breaks down these antibiotics. Consequently, CPE causes infections that are associated with high rates of death and illness, and can have severe clinical consequences. Treating these infections is increasingly difficult, as these organisms are often resistant to many – if not all – available antibiotics.

Read our toolkit for the early detection, management and control of carbapenemase-producing Enterobacteriaceae in Scottish acute settings document for more information.

Our healthcare worker and patient information leaflets give further advice about CPE screening clinical risk assessment for individuals.


MRSA Screening Pathfinder Implementation Study Reports:

View Information about several studies into MRSA screening within NHSScotland.

Relevant Chief Nursing Officer (CNO) and Chief Medical Officer (CMO) letters for the MRSA / CPE screening programme implementation:

Annual surveillance of healthcare associated infection reports

Read the latest Healthcare Associated Infection annual report below:

Healthcare Associated Infection Annual Report 2022.

View all previous annual surveillance of healthcare associated infection reports.

Annual antimicrobial use and resistance in humans reports

Read the latest Antimicrobial Use and Resistance in Humans report:

Scottish One Health Antimicrobial Use and Antimicrobial Resistance in 2022.

View all previous annual antimicrobial use and resistance in humans reports.



Read our protocol for CRA MRSA screening national rollout in Scotland.

Read our leaflet for patients on MRSA screening.


Read our toolkit for the early detection, management and control of carbapenemase-producing Enterobacteriaceae in Scottish acute settings.

Read our leaflets for healthcare workers and patients about patient screening for Carbapenemase producing Enterobacteriaceae (CPE). 

Read our toolkit for managing carbapenemase-producing Enterobacteriaceae (CPE) in Scottish non-acute care settings.

Infection prevention and control

For infection prevention and control guidance visit the A-Z pathogens section of the National Infection and Prevention Control Manual.