is Methicillin-resistant Staphylococcus aureus (MRSA)?
Methicillin-resistant Staphylococcus aureus (MRSA) is
a type of bacteria that is resistant to certain or all types
of the beta-lactam classes of antibiotics such as penicillins,
penicillinase-resistant penicillins (e.g. cloxacillin) and
What is Vancomycin-resistant Enterococci (VRE)?
Enterococci are bacteria that are normally present in the
human intestines and in the female genital tract and are often
found in the environment. These bacteria can sometimes cause
infections. Vancomycin is an antibiotic that is often used
to treat infections caused by enterococci. In some instances,
enterococci have become resistant to this drug and thus are
called vancomycin-resistant enterococci (VRE).
Risk factors for MRSA and VRE
Risk factors for MRSA acquisition include invasive procedures,
prior treatment with antibiotics, prolonged hospital stay,
stay in an intensive care or burn unit, surgical wound infection
and being a close contact of a colonized person. MRSA can
also be transmitted from mother to child through breast milk.
Risk factors for VRE include severity of underlying illness,
presence of invasive devices, prior colonization with VRE,
antibiotic use, close contact with a colonized person and
length of hospital stay.
How are MRSA and VRE transmitted?
The single most important mode of transmission of both MRSA
and VRE in a health care setting is via the hands of health
care workers who acquire it from contact with colonized or
infected patients, or after handling contaminated material
or equipment. The unrecognized colonized patient presents
a particular risk for transmission to other patients.
How are MRSA and VRE diagnosed?
All patients admitted to TBRHSC are screened for any risk
factors of an antibiotic resistant organism. Risk factors
include but are not limited to:
a) those previously in a health care facility (for greater
than 12 hours) within the past 12 months
b) those living in a communal type setting (correctional
facility, homeless shelter, etc.)
c) those having home health care or on dialysis
d) those with any history of injection drug use
Those patients indicating “yes” to risk factors
for MRSA or VRE are screened with both nasal and rectal swabs.
How are MRSA and VRE treated?
Treatment depends on how sick patients are with the disease
and whether they have an infection or are colonized with the
What precautions are used to prevent the spread of
both MRSA and VRE in the hospital?
All patients with MRSA or VRE are “flagged” on
the electronic medical record for future visits. This way
staff can take precautions upon their arrival. These extra
steps will include placing the patient in a private room with
additional precautions that will include gowning, gloving
for any patient or patient environment contact as well as
hand hygiene before and after all contact with patient. At
TBRHSC, all visitors entering the room of a patient with additional
precautions in place (on “isolation”) will be
required to wear a gown and gloves.
Thunder Bay Regional Health Sciences Centre reports on a
quarterly basis hospital acquired Methicillin-resistant Staphylococcus
aureus (MRSA) and Vancomycin-resistant Enterococci (VRE) bacteraemia
What will be publicly reported?
TBRHSC will post its quarterly rate and case count of new
MRSA and VRE bacteraemia acquired in their facility on their
website. At the end of each quarter, the Ministry will report
the previous quarter’s data on its website.
What does hospital-acquired mean?
Sometimes when patients are admitted to the hospital they
get infections. This is a hospital-acquired infection. In
the case of either MRSA or VRE, this may mean that symptoms
began 72 hours after admission to the hospital; or that the
infection was present at the time of admission but was related
to a previous admission to the hospital within the last four
What determines the rate?
The total number of new cases of MRSA and VRE bacteraemia
acquired in the hospital in a quarter is divided by the total
number of patient days for that quarter. Patient days are
the number of days spent in a hospital for all patients. The
results are multiplied by 1000. This represents the rate of
hospital acquired associated MRSA and VRE bacteraemia associated
with the reporting facility per 1000 patient days for that
quarter. The rates of infection will be calculated by quarter.
What will the health care system do with the rate
Hospital acquired infection rates provide one measure of
patient safety and quality of care. The rate of hospital acquired
MRSA bacteraemia and VRE bacteraemia will be used to analyze
any trends province wide of infection, sources of infection
and general surveillance of MRSA and VRE bacteraemia. It can
also assist hospitals to evaluate the effectiveness of infection
prevention and control interventions and make further improvements
based on this information.
Click here for
TBRHSC Patient Safety Indicators
:: back to top ::