The collective term multi-resistant gram-negative bacteria (MRGN bacteria) refers to a large group of various bacteria that differ in some characteristics but have one thing in common: They are resistant, i.e. non-susceptible, to common antibiotics. A distinction is made between bacteria that are non-susceptible to either four (4MRGN) or three (3MRGN) specific groups of antibiotics.
Depending on the group of bacteria, the pathogens are found in the gastrointestinal tract of animals and humans, or on the skin, less commonly in the nasopharynx, in the anal area or on raw foodstuffs. Resistant bacteria occur particularly often where lots of antibiotics are used, which is why they have been an increasing problem in the treatment of hospital patients over the last few years. MRGN bacteria now also colonise about five in 100 healthy persons in the general population. Healthy people who are colonised with MRGN bacteria are referred to as MRGN carriers. However, the pathogens pose no danger to these persons because a healthy immune system provides protection against infections. Treatment only becomes necessary if, for example, MRGN bacteria on the skin or in the intestines enter wounds or the bloodstream, causing an MRGN infection.
From human to human
The bacteria can be transmitted between humans by direct contact. The main route of transmission is unwashed hands.
Via objects or foodstuffs
The bacteria can survive on surfaces for a few days or weeks. Wet surfaces such as sinks, showers or toilets may also be colonised with MRGN bacteria. By touching contaminated raw foodstuffs, objects or clothing, the bacteria can be transmitted to the hands, from where they can spread further. The consumption of contaminated food may also result in the colonisation of the intestinal tract with MRGN bacteria.
From animals to humans
Transmission is also possible by contact with animals, in particular with poultry, pigs, cows and domestic animals.
An MRGN infection can cause various symptoms, depending on the location of the infection in the body. Possible symptoms include fever, wound infections and inflammations of the urinary or respiratory tract. Bloodstream infections, which involve the bacteria entering the bloodstream, are also feared. Infections with MRGN bacteria are more difficult to treat than infections with bacteria that exhibit no resistance to antibiotics. These infections often persist for a long time and may be associated with an increased mortality rate.
MRGN carriers whose skin, mucous membranes or intestines are colonised have no symptoms and do not necessarily develop an infection. An infection can break out if pathogens find their way into internal organs of the body, for example as a result of medical interventions or a weakened immune system. The infection is contagious as long as MRGN bacteria can be detected.
Healthy MRGN carriers and their contacts are usually not at risk of developing an infection. Persons with a weakened immune system, open wounds, skin or chronic diseases as well as persons who frequently undergo medical interventions are at particular risk of becoming infected with MRGN bacteria.
Your local health authority can provide you with further advice and information. Networks for fighting multi-drug-resistant organisms (MDRO) have been established throughout Germany. You can obtain contact details from your local health authority.
More (specialist) information is also available online from the Robert Koch Institute (www.rki.de/mrgn).
For more information about how hygiene can prevent infections and about the proper use of antibiotics, please visit the website of the Federal Centre for Health Education (www.infektionsschutz.de).