Infection prevention and control for multidrug-resistant organisms in adult social care settings

Main messages

multidrug-resistant organisms (MDROs) are pathogens that do not respond to common treatments such as antibiotics, antivirals, antifungals and antiparasitics, making them difficult to treat

MDROs spread through direct contact (including care activities) and indirect contact (for example, contaminated surfaces or equipment)

individuals at higher risk of infection include those with wounds, medical devices, or weakened immunity. Carriage without symptoms is common, not harmful, and can last years

it is usually safe to admit or readmit someone with current or previous MDRO carriage. Good infection prevention and control (IPC) practices will lower the chance of spread

main contributors to spread include poor hand hygiene, contaminated environments, and unclean equipment

it is important to balance safety with dignity, autonomy, and inclusion for individuals carrying MDROs

Summary of recommendations

clean hands before and after contact with individuals with a MDRO using soap and water or alcohol-based hand rub

support individuals with a MDRO to clean their hands frequently and remind visitors to clean their hands too

promote good respiratory hygiene and improve ventilation when respiratory infections are suspected or confirmed

use personal protective equipment (PPE) such as gloves, aprons, masks, and eye protection if there is a risk of blood or body fluid exposure

clean the environment daily, focusing on high-touch areas

disinfect shared equipment before and after use

clean and dirty linen should be kept separate at all times

wash infectious linen at high temperatures

follow standard waste disposal procedures unless advised otherwise

accommodate individuals with an MDRO in single rooms with ensuite if possible

let healthcare staff know about MDRO carriage during admission or transfer

Read the full guidance here.