Multi-drug resistant organism admission screening

Published on 15 October 2024

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

Our patient information leaflets give further advice about MRSA screening clinical risk assessment for individuals.

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.

Our healthcare worker and patient information leaflets give further advice about CPE screening clinical risk assessment for individuals.