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
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.
Publications
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.
Guidance
MRSA
Read our protocol for CRA MRSA screening national rollout in Scotland.
Read our leaflet for patients on MRSA screening.
CPE
Infection prevention and control
For infection prevention and control guidance visit the A-Z pathogens section of the National Infection and Prevention Control Manual.