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UNDERSTANDING HRMO

For patients and family

Introduction

Some micro–organisms, bacteria, in particular, can become resistant to certain antibiotics or combination of antibiotics.

We all carry bacteria in and on our bodies, even when we are healthy. These are called “resident bacteria.”

Anytime we misuse or overuse an antibiotic the resident bacteria are attacked. Some survive and adapt to the new antibiotic environment. They make antibiotic resistant genes and pass those genes on to bacteria that make us sick, making them resistant too.

These are called HRMO, Highly Resistant Micro-Organisms that are resistant to the most commonly used antibiotic.

Resistant means the antibiotic does not work to treat infections caused by that type of bacteria.

Misuse is when you stop taking the antibiotic your doctor prescribed as soon as you feel better. Overuse is when you use antibiotics unnecessarily, for example when you have a

Healthy persons, who carry HRMO, generally do not get sick from it. The risk is that the healthy person can, through hand contact, pass on the HRMO to someone who can get sick from it (e.g. someone with a low immune system).

Because infections with HRMO are more difficult to treat, the hospital takes measures to prevent the spread of these resistant micro-organisms.

Who is tested for HRMO?

  • Patients who were treated in a hospital abroad, less than 2 months ago.
  • Patients from a department in a hospital that is experiencing an HRMO epidemic.
  • Patients in contact with a roommate who is an HRMO carrier.

Testing for HRMO

Swabs will be taken from the patient for culturing.

Isolation

To prevent the spread of HRMO to other patients and staff, the HRMO carrier or suspected HRMO patient is placed in isolation.

They are taken care of in a single bed room under a certain isolation type; which is based on the kind of HRMO and the place on the body where it is isolated. The nurse will explain on admission in which isolation type the patient will be placed in.

Persons entering the isolation room will wear protective gear according to the type of isolation. Visitors should contact a nurse before entering. When leaving they must disinfect hands with alcohol. They are not allowed to visit other patients.

The HRMO patient is flagged in the hospital information system. If the patient is readmitted a signal would appear immediately in the system and precautionary measures will be taken with the patient.

Declaring the patient HRMO negative

To determine if the patient known with HRMO is no longer a carrier, the results of two series of cultures are negative for growth of HRMO. The tests are done:

  1. after complete recovery,
  2. no earlier than 3 months after discharge,
  3. 48 hours after discontinuing antibiotic.

The patient is considered completely HRMO free when negative of HRMO after one year.

What can you do to prevent the spread of HRMO?

The most important measure to prevent the spread of HRMO is to practice hand hygiene;.

You can use hand-alcohol when your hands are not visibly dirty.

Wash your hands with soap and water:

  • when visibly soiled or sticky
  • after visiting the toilet, also after the use of a bedpan or urinal
  • before and after eating
  • after sneezing and coughing

You should always cough with your face turned away from others.

Cough in your elbow or a disposable napkin.

Always use a napkin once and discard.

If you are an HRMO patient, you must practice good hygiene to reduce the amount of; bacteria on your skin

Caring for yourself in the hospital

In the hospital you are allowed to wear your own clothes and use your own toiletries.

Your dirty clothes can be given to your family in a plastic bag. The dirty clothes can be washed in the washing machine in no less than 40 degrees Celsius water, preferable 60 degrees or disinfected with bleach (Clorox). When discharged, you must take all your belongings with you.

Caring for yourself at home

Many bacteria that are dangerous in a hospital are not a danger for healthy persons. You could go home without extra measures. You and your family at home should wash hands when necessary.

Continued medical care

Your attending specialist in the hospital will inform your family physician about you being an HRMO carrier. The nurse will inform the district nursing, if you have home care. They will take the necessary precautions when they visit you.

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