Download MRGNB (Multi-resistant Gram

MRGNB (Multi-resistant Gram-Negative Bacteria)
Information for service users in the community
What are Multi-resistant Gram-Negative Bacteria?
Some types of bacteria (germs) have developed the ability to be resistant to many commonly
used antibiotics. Not only are they antibiotic resistant, but they can also pass on this
resistance to other species of bacteria.
The types of bacteria that most commonly develop this ability include: Escherishia Coli,
Klebsiella, Proteus, Pseudomonas, Enterobacter and Acinetobacter species (these bacteria
are known as Gram-negative bacilli-GNB).
If these bacteria cause an infection, for example, urinary tract infection, pneumonia or
surgical wound infections, they are very difficult to treat as they are resistant to many
antibiotics.
It is important to remember that Multi-Resistant Gram-Negative bacteria usually pose
no problems for people who are fit and well, but are a risk to vulnerable patients and
service users in hospital and care establishments.
Where are these bacteria found?
These bacteria are commonly found in our gastro-intestinal tract (gut) where they are part of
our ‘healthy’ bacteria. They can also be found in the environment, in water, soil, on
healthcare workers’ hands, and equipment used in healthcare settings. These bacteria are
often found in faeces or urine specimens.
How can these bacteria be passed on?
As the bacteria can be found in the gastrointestinal tract they can be passed to others or in
the environment on our hands if hands are not washed after using the toilet.
Are there any special precautions?
Service users with multi-resistant Gram-Negative bacteria should be encouraged to live a
normal life without restriction. Often service users do not have any symptoms and they do
not require treatment. However, we do not want these bacteria spreading to others for whom
such bacteria may cause an infection. Therefore, the following precautions are required:
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A single room is required if the resident or the resident with whom they share with has an
open wound, catheter or drip.
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If applicable, a designated commode should be used.
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The promotion of good hand hygiene by all healthcare workers, the resident and visitors.
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Staff should wear a disposable apron and gloves when providing direct hands-on care
and wash their hands or apply alcohol handrub after an episode of care.
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Staff should ensure that cuts and grazes are covered with a waterproof dressing.
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What treatment is required?
The majority of people with multi drug resistance bacteria do not have any symptoms and do
not require treatment. Only if a person has an active infection will be prescribed antibiotics.
How can the spread of these bacteria be prevented?
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Hand hygiene is the most important way of preventing the bacteria spreading. Hands
should be washed with liquid soap and warm water or alcohol handrub used after an
episode of care.
Service users should be encouraged/assisted to wash hands after visiting the toilet and
before meals.
Clothing, towels, and bed linen if contaminated with body fluids should be washed
separately from other service users items in a washing machine at the highest
temperature recommended by the manufacturer.
Any body fluid spillages must be dealt with immediately.
Will the bacteria always be present?
Since most people do not have any symptoms of a multiple antibiotic resistant bacteria and,
therefore, do not require treatment, it is difficult to say for sure if the bacteria are still present
after a period of time.
If treatment in hospital as an in-patient or out-patient is required in the future, the hospital
should be informed that you have had an MRGNB or ESBL in the past.
Are visitors at risk?
There are no restrictions on visiting and normal physical contact can be maintained. These
bacteria do not usually cause a problem to anyone unless they themselves are ill. However,
visitors should consider the following:

If they are visiting other hospital patients or health and social care establishments, your
visit should be the last of the day.

Hands should be washed before and after visiting.
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Cuts/grazes should be covered with a waterproof dressing.

Disposable gloves and aprons are not required unless visitors are providing care, such
as help with washing.
North Yorkshire and York Community Infection Prevention and Control
Harrogate and District NHS Foundation Trust
Gibraltar House, Thurston Road, Northallerton, North Yorkshire. DL6 2NA
Tel: 01423 557340
www.infectionpreventioncontrol.co.uk
Version 1.02
January 2015
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