DO YOU KNOW...

Multidrug-resistant organism (MDRO)

 

What is MDRO?

A multidrug-resistant organism (MDRO) is a germ that is resistant to many antibiotics. Antibiotics are medicines used to stop the growth of bacteria that cause infection. Certain commonly used antibiotics will not work to treat infections with MDRO. That is what is meant by the MDRO being resistant to antibiotics. This makes infections caused by MDROs hard to treat and cure.

Examples of MDROs include:

  • CRE (Carbapenem-resistant Enterobacteriaceae) – CRE is a family of germs that are not easily treated with antibiotics such as meropenem. The germs have become resistant to nearly all other antibiotics. Many people call these CRE germs “superbugs.”
  • ESBL (Extended-spectrum Beta-lactamases) – Beta-lactamases are enzymes produced by some bacteria. These enzymes make some germs resistant to antibiotics such as cefepime, ceftriaxone, and penicillin. So, these antibiotics cannot be used to treat infections caused by a germ that has ESBL.
  • MRSA (methicillin-resistant Staphylococcus aureus) – MRSA is a bacteria that is resistant to many antibiotics. MRSA can cause a variety of problems including skin infections, sepsis, pneumonia, and blood stream infections.
  • VRE (vancomycin-resistant enterococcus) – A type of bacteria called enterococci has developed resistance to many antibiotics, especially vancomycin. VRE can cause serious infections in the intestines, urinary tract, and wounds. See “Do You Know… VRE (vancomycin-resistant enterococci)” for more details.

What causes MDROs?

MDROs can come from germs that are normally found in a person’s digestive tract or on their skin but can become MDROs after taking antibiotics. MDROs develop when antibiotics are taken longer than needed or when they are taken even though they may not be needed.

How do MDROs spread?

MDROs spread from patient to patient on the hands of health care workers, visitors, or family members. They can also spread on objects or surfaces that have been contaminated with the germ, such as bed rails, bedside tables, IV poles, and catheters. MDROs can also spread by touching people who carry the germs or by contact with their bodily fluids (such as drainage from a wound, urine, stool, saliva, or blood).

Why is it important to know about MDROs?

At times, an MDRO can make your child sick. Also, it may spread to other children with weak immune systems and make them sick. In some cases, an MDRO can be present on or in your child’s body but not cause any illness. In such cases, the patient is said to be “colonized.” For example, CRE bacteria can be found in your child’s gut without causing any illness. However, at times, the bacteria might spread to a part of the body where those germs are not usually found such as the blood. This can cause an infection and make your child ill.

What are some risk factors for MDRO infections?

Healthy people usually don’t get MDRO infections. Risk factors for getting an MDRO include:

  • Chronic illness,
  • Weakened immune system,
  • Prolonged use of antibiotics,
  • Use of medical devices such as central venous catheters (central lines) or urinary catheters, and
  • The patient colonized with an MDRO in the past.

Patients with cancer are more likely to get an MDRO infection. The infection might be related to:

  • Neutropenia (a low level of neutrophils – a type of white blood cell that fights infection),
  • Mucositis (mouth sores),
  • Lymphocyte dysfunction (higher than normal level of lymphocytes – a type of white blood cell that helps fight infection), and
  • The use of medical devices that are placed fully or partially inside the body, such as catheters and ports.

How are MDROs treated?

MDROs are hard to treat because they are resistant to many common antibiotics. But, a few antibiotics can be used. Your doctor will decide which antibiotics to prescribe based on the germ and location of the infection.

How can the spread of MDROs be prevented?

Several precautions can help prevent the spread of MDROs:

  • Limit antibiotic use: Using antibiotics only when needed, and for the shortest time possible, helps prevent MDROs.
  • Washing hands: One of the best ways to control the spread of germs and prevent infections is proper hand washing with soap and water or using alcohol-based hand sanitizer. If washing your hands with soap and water, press firmly and rub your hands together for at least 15 to 20 seconds, rinse well, and dry thoroughly. Soap and water is the preferred method after using the restroom, changing diapers, and cleaning up a child who has used the toilet. See “Do You Know… Clean Hands” for more details.
  • Isolation precautions: If your child has an MDRO, they will be placed in Contact Precautions. This means that staff and visitors should wear gloves and a gown before entering the patient’s room, and remove them before leaving the patient’s room and wash hands. Sometimes, a mask is also required. See “Do You Know… Contact Precautions” for more details.
  • Disinfecting the environment: Your child’s hospital room and everything around the patient will be cleaned daily by our staff using an approved disinfectant.
  • Daily bathing with chlorhexidine gluconate (CHG) wipes and daily linen change while in hospital. Keeping a clean body and bed is important for preventing the spread of germs. CHG wipes have been shown to reduce the risk of patients being colonized and infected with MDRO.

Questions?

If you have questions about MDROs, talk to your child’s St. Jude doctor or nurse.


 

This document is not intended to take the place of the care and attention of your personal physician or other professional medical services. Our aim is to promote active participation in your care and treatment by providing information and education. Questions about individual health concerns or specific treatment options should be discussed with your physician.

St. Jude complies with health care-related federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

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