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HF 7259

What You Need to Know about Multidrug-Resistant and Extensively Drug-Resistant Infections

This handout explains what multidrug-resistance (MDR) and extensively drug-resistance (XDR) means and how it impacts your care at UW Health.

What does MDR and XDR mean?

Germs that are MDR are not killed by many drugs used to treat infections. This means that there are fewer drugs to kill these germs. XDR germs are specific germs that are harder to treat than MDR germs.  

MDR and XDR germs are becoming more common. We often have these germs on our skin or inside our body with no problem. However, these germs can cause many kinds of infections in people, such as in the urine, lungs, blood, and surgery sites. 

Who is most likely to get these infections?

Anyone; however, most occur in the elderly or people who:

  • Have other health problems.

  • Have weak immune systems.

  • Have a need to use antibiotics for a long time.

  • Have frequent contact with the health care system.

  • Live in a nursing home or assisted living. 

Can they be treated?

There are a few antibiotics that kill these germs and stop the infections. Not all patients with MDR germs need antibiotics. Sometimes the germs live on the skin and in the body and do not cause infection.  

XDR germs tend to stay in the body (usually in the intestines). That is why once your medical record shows you have had this type of infection, it stays in the medical record forever.

How will this change my care in the hospital?

  • Be sure to tell the health care team that you have had an MDR or XDR infection in the past. For example: “I was diagnosed with XDR in the urine in June 2017.”

  • Health care workers will wear gowns and gloves when they care for you. This is known as contact isolation precautions. This lowers the risk of spreading these germs to other patients.

  • Make sure your health care team washes their hands with soap and water or uses an alcohol hand gel before and after they care for you. If you do not see them clean their hands, do not be afraid to ask them to do so.

  • Clean your hands often. Be sure to clean them after you use the bathroom and before you eat.

  • Put on a clean robe or a clean hospital gown and clean your hands before you leave your room. Keep the robe on while you are outside your room.

  • Stay on the inpatient unit. Avoid direct physical contact with patients, kitchen or lounge areas. 

Can my family and friends visit me in the hospital? 

In most cases, you can have visitors, but they are asked to follow the same rules as the health care workers. This means they need to wear gowns and gloves to go into your room, take off their gowns and gloves when they are ready to leave your room and clean their hands with soap and water or alcohol hand gel.

Visitors that spend the night should speak with the nurse about wearing gowns and gloves. 

Friends and family members should not visit if they have any signs of an illness that can be spread from person to person. This includes a cough, sore throat, fever, rash, or diarrhea.  

How will this change my care in the clinic?

Be sure to tell the health care workers that you have had an MDR or XDR infection in the past. For example: “I was diagnosed with XDR in the urine in June 2017.”

In some clinic settings, health care workers will wear gowns and gloves when they care for you. This is known as contact isolation precautions. This lowers the risk of spreading these germs to other patients.

Make sure your health care team washes their hands with soap and water or uses alcohol hand gel before and after they care for you. If you do not see them clean their hands, do not be afraid to ask them to do so.

What do I need to do in my home?

There are a few things you should do to decrease the chance of getting an MDR or XDR infection again and spreading it to others.

  • If you get medicine to treat an infection, take it exactly as the doctor and pharmacist say. Be sure to take all of the medicine as prescribed. 

  • Clean your hands with soap and water or alcohol hand gel often. Be sure to clean them after you go to the bathroom, before you touch food and before and after wound care.

  • Let the people who live with you know they should clean their hands often.

  • Do not share personal items like towels or razors.

  • Wash and dry your clothes and bed sheets in the warmest washer temperatures written on the clothes labels.

  • Keep cuts and scrapes clean and covered until healed. Do not touch other people’s cuts or bandages.

  • Follow your doctor’s instructions.

References

Management of Multidrug-Resistant Organisms in Healthcare Settings, 2006. Centers for Disease Control and Prevention. http://www.cdc.gov/hicpac/mdro/mdro_toc.html

Guidance for Control of Infections with Carbapenem-Resistant or Carbapenemase-Producing Enterobacteriaceae in Acute Care Facilities.  MMWR March 20, 2009. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5810a4.htm