Multidrug-resistant organisms (MDROs)

What are multidrug-resistant organisms (MDROs)?

There are lots of bacteria living on our bodies and in our guts. Sometimes, these bacteria can become resistant to regular antibiotics. When bacteria become resistant, it means the usual medicines we use to treat infections caused by them might not work anymore. Multidrug-resistant organisms (MDROs) are special bacteria that are resistant to many antibiotics, including some of the strongest ones we have. This makes them more difficult to treat. Carbapenemase-producing Enterobacterales (CPEs) are MDROs that are resistant to some of our last line antibiotics; that’s why some people call them superbugs.

How are MDROs and CPEs diagnosed?

Most of these bacteria live in our guts. To find out if a child has a very resistant bacteria, doctors may take a swab from their poo and send it to a lab to see if any resistant bacteria are there. If someone has a urinary catheter or open wounds, samples might be taken from those places too.

Why has my child been tested?

Children who have been in the hospital or on specific antibiotics are more likely to have these resistant bacteria. That's why we test children who come from other hospitals and those on the strongest antibiotics to make sure new resistant bacteria aren't growing in their gut. Early identification of children with a very resistant bacteria  allows hospitals to put measures in place to reduce the risk of them spreading it to other children.

What happens if my child has a very resistant bacteria (CPE/MDRO)?

If your child has a very resitant bacteria in their gut, they probably won’t have any symptoms. That’s because these bacteria usually sit harmlessly in your child’s gut (colonisation) rather than causing an infection. If your child does develop an infection from a very resitant bacteria, the hospital's infection experts will decide the best treatment. To stop these bacteria from spreading, your child will be cared for in isolation (a single room), and hospital staff will wear gloves and gowns. An alert will also be added to your child's electronic record. Although your child's treatment won't change, some procedures or scans might be rescheduled to lower the risk of spreading the infection; they may be  last on a list so that extra cleaning can be done before the next patient.

How can I reduce the risk of spreading the infection to other children in hospital?

To help stop the spread, we ask parents and family of children with very resistant bacteria to:

  • Not use shared kitchens on the ward.
  • Wash your hands regularly, especially before leaving the side room.
  • Avoid playing with other children on the ward.
  • Not let your child or their siblings use the playroom.

What will happen if my child is re-admitted to hospital ?

If your child is seen at any hospital or is re-admitted please tell the staff that your child has a very resistant bacteria. This is important for staff to know so the correct antibiotics are prescribed for your child if they have an infection and to ensure that your child will be cared for in a side room. The same precautions of staff wearing gown and gloves will restart each time your child comes into hospital.

What happens when my child comes for an outpatient appointment ?

When your child comes for an appointment, to reduce the risk of spreading the bacteria please do not let them play with other children or toys in the waiting area. Staff will wear gown and gloves if they need to examine your child. Your appointment may be at the end of the session so that extra cleaning can be organised.

How long will my child have a very resistant bacteria CPE/MDRO ?

Very resistant bacteria can live in the gut for a long time. When your child comes back into hospital we will take another swab to see if the bacteria are still there. If after 12 months the tests show the bacteria is no longer in the gut the alert may be removed, the results will be reviewed by a senior member of the infection prevention team and the extra precautions of being in a side room and staff wearing gown and gloves may be stopped.

Do we need to take any precautions at home or school?

No, there are no extra things you need to do. We always recommend good hygiene, like washing hands before eating and after using the toilet. You don't need to tell the school that your child has a very resistant bacteria

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