What is MRSA

Multi-resistant pathogens - what you should know about them

How does a bacterial infection develop?

Bacteria are known to be pathogens. But they also protect our health: Many bacteria naturally colonize our skin and the mucous membranes of the mouth, nose, intestines and other organs. Together they form a protective barrier. They make it more difficult for pathogens that cause illness to penetrate our body. If the immune system is weakened or the skin and mucous membranes are damaged, both foreign and endogenous pathogens can enter the body and trigger an infection. Common bacterial infections are pneumonia, urinary tract infections, wound or skin infections.

If the bacteria spread through the blood in the body, this is known as blood poisoning. In the worst case, organ functions can fail. That can be life threatening. Antibiotics are usually effective drugs for bacterial infections. They kill or weaken the bacteria.

How do multi-resistant pathogens arise?

Bacteria multiply very quickly and in large numbers. The genome can change in such a way that these pathogens become insensitive to antibiotics. These bacteria survive antibiotic treatments and pass on their resistance. If bacteria are resistant (resistant) to many antibiotics, one speaks of Multi-resistance. In principle, these bacteria are no more dangerous than others. They also don't cause infections more often. But if an infection does occur, it is far more difficult to treat. Because only a few antibiotics are effective here. Laboratory tests can be used to find out which antibiotics still help and which don't.

Multi-resistant bacteria arise mainly because antibiotics are not used correctly, i.e. too often, too short or too low a dose.

Risk factors for MDRO infections

For healthy people with a good immune system, multi-resistant pathogens are usually harmless. That means: If you come into contact with these bacteria, the risk of getting sick is very low. Healthy people can carry multi-resistant pathogens without becoming ill themselves. Most of them do not know that they are MRE carriers. This becomes problematic when they unconsciously transmit these pathogens to people with weakened immune systems. These are particularly at risk of developing infections, which can then be more difficult to treat. The following factors increase the risk of getting an MDRO infection:

  • Clinic stay within the last 6 months
  • Stay in a nursing home
  • permanent need for care
  • Antibiotic therapy within the last 6 months
  • open, larger, poorly healing skin wounds
  • Tubes (catheters) in the body, such as in the bladder
  • Diseases that weaken the immune system, for example diabetes mellitus, hepatitis, HIV
  • Drugs that suppress the immune system

For healthy MRE carriers, the pathogens can be a risk if they are operated on. The MRE can penetrate the surgical wound and cause an infection.

How common are MDRO infections?

MRE infections are most likely to occur in facilities in which many sick and weak people are cared for, i.e. in hospitals and nursing homes. There are many patients with risk factors, especially in hospitals. This is why the risk of infections is greatest here: in Germany, around 500,000 people develop hospital infections every year, often through the body's own bacteria. Around 30,000 infections are caused by multi-resistant pathogens. This means that around 6 out of 100 hospital infections are caused by MDROs.

What you can do yourself

  • The best protection against infection is not to spread pathogens. You can do this if you follow hygiene rules. Many pathogens spread through direct contact via the hands. Therefore, the first thing is: regular and thorough hand washing.  
  • Towels, washcloths, and toiletries such as toothbrushes should only be used for yourself.
  • Your living area should be clean. Common household cleaners are sufficient for this. Special disinfectants may be required if a loved one has an infectious disease or a weak immune system. Get medical advice.
  • Most pathogens do not survive temperatures above 60 ° C. Wash your dishes and laundry regularly at higher temperatures.
  • If you are healthy, you can maintain normal contact with MRE carriers. Hugs are also possible. The risk of infection is extremely low. Wash your hands well afterwards.
  • In the hospital, MDRO carriers or patients with MDROs must follow special hygienic rules in order not to pass MDRO on to other patients. Please take into account the information provided by the staff.
  • If you have open wounds or a severely weakened immune system, you should avoid contact with MDRO carriers or people suffering from MDRO.
  • If your doctor prescribes antibiotics for you, be sure to use them as prescribed.

  • A general check as to whether you are an MRE carrier is not required. Not even if you have had contact with someone with MDRO.

  • You may need an operation and have a risk factor for MDRO. Then you should discuss with your doctor whether a test for MRE in advance can be useful.

June 2019, published by the German Medical Association and the National Association of Statutory Health Insurance Physicians