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Multidrug-Resistant Organisms (MDROs)

Some germs have become resistant to the medications (antibiotics) used to treat them. This means the antibiotics no longer work to kill those germs. Germs that resist treatment with more than one antibiotic are called multidrug-resistant organisms (MDROs). MDROs mainly affect people in hospitals and long-term care facilities. But they are also spreading among healthy children and adults. When a person carries an MDRO but is healthy, it’s called being colonized with an MDRO. This person can spread the MDRO to others. When a person gets sick because of an MDRO, it’s called being infected with an MDRO. This person can also spread the MDRO to others. If not treated properly, an MDRO infection can be fatal. Here you will learn more about MDROs and what can be done to prevent them.

Health care provider washing hands in hospital room.

What Causes MDROs?

Hard-to-kill germs, such as MDROs, are caused by the misuse of antibiotics. Misuse is when antibiotics are taken longer than necessary or when they’re not needed. At first, only a few germs may survive treatment with an antibiotic. But the more often antibiotics are used, the more likely it is that resistant germs will develop.

What Are the Risk Factors 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

  • A current or recent stay in a hospital or long-term facility

  • Previous use of antibiotics

  • Having invasive procedures, such as dialysis

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

  • Previous MDRO colonization or infection

  • Older age

How Are MDROs Spread?

MDROs are most often spread through skin-to-skin contact. They can also spread through shared items or close contact with a colonized or infected person:

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

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

What Types of Infections Can MDROs Cause?

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

  • Skin

  • Lungs

  • Urinary tract

  • Bloodstream

  • Wounds

How Is MDRO Colonization Treated?

People who are colonized with an MDRO do not usually need treatment. But, they are advised how to help prevent the spread of the MDRO to others. Depending on the type of MDRO a person has, he or she may undergo a process called decolonization. Your doctor will let you know more about this treatment if needed.

How Are MDRO Infections Treated?

MDRO infections can be hard to treat. This is because they don’t respond to many common antibiotics. But certain antibiotics can still help control MDROs in most people. The doctor will try to find the type of MDRO causing the illness. This can help choose the best antibiotic. Treatment with the wrong antibiotic can slow recovery. It can also make the infection harder to cure.

Preventing MDROs: What Hospitals and Long-Term Care Facilities Are Doing

Many hospitals and long-term care facilities take these measures to help prevent the spread of MDROs:

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

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

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

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

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

  • Vaccination. People living in long-term care facilities may receive vaccines to help prevent problems caused by MDRO infections, such as pneumonia.

  • Monitoring. Hospitals monitor the spread of MDROs and educate caregivers on the best ways to prevent it.

Preventing MDROs: What Patients Can Do

  • 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 that contains at least 60% alcohol.

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

  • If you have a urinary catheter, ask to have it removed as soon as possible.

Preventing MDROs: What Can Be Done Outside the Hospital

  • Keep your hands clean. Do this by washing your hands often. Or use an alcohol-based hand gel.

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

  • Avoid contact with the wounds or bandages of others.

  • Avoid sharing towels, clothing, and sports equipment.

Precautions When Caring for Someone with an MDRO

  • 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 linen, 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.

Tips for Keeping Your Hands Clean

When washing your hands:

  • Use warm water and plenty of soap. Work up a good lather.

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

  • Wash for at least 15 seconds. Singing "Happy Birthday" or the "Alphabet Song" are examples of how long 15 seconds would be. Don’t just wipe. Scrub well.

  • Rinse, letting the water run down your fingers, not up your wrists.

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

When using alcohol-based gels:

  • Spread about a tablespoon of gel in the palm of one hand.

  • Rub your hands together briskly. Be sure to clean the backs of your hands, the palms, between your fingers, and up the wrists.

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


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