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Multidrug-Resistant Gram-Negative Organisms (MDRGNO)

Information for patients, relatives and visitors

        What are MDRGNO?

        MDRGNO stand for Multidrug-Resistant Gram-Negative Organisms. They are a group of bacteria (germs) that are resistant to at least three different antibiotics.
        These bacteria are commonly found in the gut or skin, where they do not cause any harm – this is called ʻcolonisationʼ. If the bacteria enter the body through an open wound or invasive medical device, for example a urinary catheter, this can cause infection.

        How do you test for MDRGNO?

        If you need a sample to be taken for testing, a member of your care team will discuss this with you. Normally a full screening is done, including a rectal swab (this involves inserting a swab a small way into your bottom) and skin swabs. You may need to give some other samples, for example, a sputum sample (spit) or a sample of urine.
        You should not experience any discomfort while samples or swabs are taken. Your privacy and dignity will be respected at all times when these samples are taken.
        All swabs and samples will be sent to the laboratory to see which bacteria grow. Your care team will tell you the results (the results can take approximately one to three days).
        You may be cared for in a single room until the result of your test is known. This is to prevent the possible spread of infection to other patients.

        What if the test for MDRGNO is negative?

        This means that you are probably not colonised or infected with any MDRGNO and no treatment or extra care precautions are needed. If you are in a single room you may be moved back to the main ward.

        What if the test for MDRGNO is positive?

        If you test positive for any MDRGNO it means that you have the bacteria in your body. You may not have any symptoms (colonisation) or you may feel unwell and experience symptoms (this shows you have an infection). If your doctor thinks you are showing signs of infection he/she will prescribe a course of antibiotics.
        While you are in hospital:
        • You will be cared for in a single room with your own toilet facilities.
        • Staff caring for you will wear personal protective equipment, for example gloves and aprons, to prevent the spread of the bacteria to other patients.
        • It is very important that you wash your hands thoroughly with soap and water after visiting the toilet and before eating (staff will help you with this if necessary).
        • It is very important that all healthcare staff and your visitors wash their hands with soap and water before entering and leaving your room.
        • You should avoid touching medical devices, for example intravenous drips or catheters (if you have any). You should avoid touching open wounds (if you have any).

        What is the treatment for MDRGNO?

        If you test negative for or are colonised with MDRGNO you will not receive any treatment. However, if you develop an infection, antibiotic treatment may be necessary.

        How do you get MDRGNO?

        As mentioned previously, these bacteria can sometimes live in the gut or on the skin of humans, so it can be difficult to say exactly how and where you got MDRGNO.
        Your risk of getting MDRGNO is increased if you have underlying medical conditions and are very ill, have been taking antibiotics, received healthcare abroad or have been in hospital previously.

        Are visitors allowed?

        MDRGNO are not a problem for fit and healthy people, and family and friends are still encouraged to visit you.
        The general advice for hospital visitors is as follows.
        • Relatives, friends and other visitors who are feeling unwell should avoid visiting.
        • Visitors who have had a recent infection or illness should get advice from nursing staff on the ward before visiting.
        • Children and babies can be more vulnerable to infection and are advised not to visit.
        • Follow instructions on the room door or from nursing staff before entering the room.
        • Visitors and relatives can still touch you (hold your hands or give you a hug).
        • Visitors must wash their hands well with soap and water before entering and leaving your room to help prevent these bacteria from spreading to others.

        What happens when I leave hospital?

        • If you have been discharged from hospital with an MDRGNO it should not affect you or your family and home.
        • Your GP will be told that you have an MDRGNO when you leave hospital.
        • Washing your hands is very important to prevent bacteria spreading. You must wash your hands after visiting the toilet and before eating. Any people who are looking after you must also wash their hands with soap and water to prevent spreading MDRGNO to other people.
        • Staff caring for you may wear gloves and aprons when carrying out certain tasks. This is to prevent the spread of MDRGNO to other patients they are caring for. Your family members do not have to wear this equipment.
        • If you have any invasive medical devices, for example a urinary catheter, you should only touch it if you have been told to clean it. Remember to wash your hands with soap and water before and after cleaning it. We will give you separate information about how to care for it.
        • You should make sure your toilets and bathrooms are regularly cleaned with your usual household cleaning products.
        • You can continue with leisure and social activities as normal.
        • You should encourage visitors and relatives to wash their hands, using soap and water.
        • Crockery, cutlery and so on can be washed as normal.
        • Clothes and bed linen can be washed as normal at the hottest temperature suitable for the fabric. If laundry is soiled, it should be washed separately, preferably at 60°C. If friends or relatives are helping you with your laundry it is important that they wash their hands with soap and water after handling the dirty laundry.

        What if I need to go back into hospital or attend as an outpatient?

        If you are admitted back into hospital or are attending as an outpatient, it is important that you let the staff caring for you know that you have had a positive test for MDRGNO in the past 12 months. This will make sure that you are tested again and receive the best care to reduce the risk of developing an MDRGNO infection. It might be helpful to take this leaflet with you to show the clinical team.

        Where can I get more information?

        If you would like more information, please speak to a member of the nursing or medical team caring for you or your relative, who may contact the local Infection Prevention and Control Team for you.
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