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What are multi-resistant Gram-negative bacteria?
Gram-negative bacteria are often found living naturally in the human gut, in water or soil. For many reasons, a small number of these bacteria can become resistant to the antibiotics that they have been sensitive to in the past. This may mean that some traditional antibiotics are no longer effective for treating infections caused by these bacteria.
‘Multi-resistant Gram-negative bacteria’ is a term that covers many different bacteria, including extended spectrum beta-lactamase (ESBL) or AmpC producing Enterobacteriaceae (such as E.Coli or Klebsiella species), some Acinetobacter species, some Pseudomonas species and Stenotrophomonas maltophilia. It does not include MRSA.
How are they spread?
Gram-negative bacteria can be passed from person to person directly or indirectly via contaminated hands or objects, and can then be introduced into the mouth, wounds or other entry sites into the body. They can also be acquired from another part of your own body. This is found most often in long-term care, or critical care settings.
The problem is usually first identified when an individual presents in hospital and a specimen of urine, blood or a wound swab is submitted to the microbiology lab for culture.
Do these bacteria always cause infection?
No. People often carry the bacteria without any symptoms or harm (called ‘colonisation’), but it can sometimes lead to infection.
What infections can multi-resistant Gram-negative bacteria cause?
MRGNB can cause the same problems caused by sensitive strains of these bacteria. This could be a wound or urinary tract infection, pneumonia, or a bloodstream infection. The resistant bacteria do not cause more dangerous infections than sensitive strains, although they may be more difficult to treat.
Can it be treated?
People who are simply colonised with the bacteria do not require treatment. In most people, these bacteria will disappear on their own over time. However, despite being resistant to many of the commonly-used antibiotics, be reassured that treatment options are still available if an infection should occur.
People may not have to stay in hospital until the infection is resolved. You may be able to go home when your general condition allows regardless of whether you are still carrying the bacteria or not.
How can the spread of these bacteria be prevented in hospital?
People in hospital are more at risk of infection because their body defences are weakened by illness, surgery, medication, and the presence of invasive devices such as urinary catheters and intravenous lines.
It is preferable for patients with multi-resistant Gram-negative bacteria to be nursed in a single room. Hospital staff involved in direct personal care will wear gloves and aprons if there is a risk of contact with blood or body fluids.
The room will be cleaned daily and any equipment that is used on multiple patients will be cleaned after each use.
The prevention of spread of bacteria relies mainly on everyone having good hand hygiene practices, particularly after using the toilet or caring for wounds or devices such as urinary catheters.
Visitors or relatives should not be affected, however they must clean their hands before and after visiting, as with any patient visited in hospital. Visitors must not sit on the beds and should not visit if they are unwell themselves.
What happens when I go home?
The presence of bacteria (which may disappear quite naturally), should not affect you or your family at home. Usual personal hygiene and household cleaning is sufficient and there are no restrictions to activities and visitors. If you have a wound and it becomes red, swollen or oozes, or you develop a fever, then please contact your GP as usual.
Contact us
If you have any queries relating to this information, please contact the Infection prevention and control (IPC) service.
About this information
Service:
Infection prevention and control (IPC)
Reference:
LL/010
Approval date:
23 December 2024
Review date:
1 December 2027
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.