----------------milS15~ ,-------------, Prevention ,,-------------

~m~~~~$mm.~~.~~~.~,~A ~Jt*.Jl!tl:;§:~JIIBr7lJ~)ri : To prevent and conttol the ttansmission ofMDROs in the community, patients and their relatives should take extra care to perform the following:

<>ilit~~:l!f1'l91OOAIi~,:itJt~ !l'¥~~o Maintain good personal hygiene, especially keep hands clean.

<> li~~ft!?Aj:!;JtlfIl!!NIo/J~ , ~D=ErjJ , tR!\o/J 0

Avoid sharing of personal items such as towels or clothing.

<> li~H~Jtl'¥~fI!tm!!t!\o/J ' f§tJ ' 5t~!\o/Jjjl(E*pj~I¥J!\o/Jftt 0 ~Dm~ ~l:!!!PJ_tJ~!\o/J ' ff!9CIt..t:@ijOOl¥J fll!! A fljjiiUHii (~D '¥~ ) '!liz 1:EMI&l:!!!jC-$t& ' Jtl ffi-i'/UDii7.l< ffit@ii~If'¥o Avoid direct contact with excreta, wounds, secretions or contaminated objects with bare hands. Wear appropriate personal protective equipment (e.g. gloves) whenever it is necessary to handle them. Wash hands thoroughly with liquid soap and water afterwards.

<> ~DWli!l{lJiI¥JElJfjjl(f.tJ ' JJ!JtlJj(f-+~~1I~ , !lIzli~~Jtl0j:!;m~,~.jjl(7.I<~~~o If there are abrasions or cuts, cover them properly with dressings, and avoid visiting public bathrooms, massage parlors or spa.

<> ilit~:!It:l1tli~%Il!\fgJl.~l'Jo f91HmPJ JIl1lt99~~*JIl~ 87.1< (IlPre 1 -Bt5.25%~ 81j( ~99-Bt~lUt%ll) JEWHI1l$ *~~:!It:l1tiil!:»to~. *iliHIUPJ flI!JIl70%m~ m$o Maintain environmental hygiene and items cleanliness. For example, regularly disinfect furniture and facilities by using 1 in 99 diluted household bleach (i.e., adding one part of household bleach containing 5.25% sodium hypochlorite to 99 parts of water). Use 70% alcohol to disinfect metal surfaces.

Seek medical advice promptly if symptoms of infection develop.

<>~~g~n'K~~Jtlm~o Follow prescriptions by doctors and use antibiotics correctly.

OO~~~~~@Il~iilliWi'Ii~ii~iB~ , ~iJJl!c'(~fMil):

For any further information of MOROs, please visit the following websites:

http://www.chp.gov.hk

http://icidportal.ha.org.hk/

Multi-Drug Resistant Organisms (MOROs)

~~~ Department of Health

$.~.tt ••• $~.m~~~.~~~. tt'~~ •• ~M.~~.·~ •• ~m~~ m~.~~.f~M.,@~~.n~n •• ~Y.l!;'3I®.$~/i!lJf1om • ~r~$.~.'I1:. .~f9IJT : MDROs refer to those bacteria that cause infections not treatable by several classes of commonly used antibiotics. Although there are some alternative antibiotics available for treatment, they may be less effective, or cause more side effecrs. Here are some examples ofMDROs:

<>~ ffl ~n!i*~.1ii~J>$ii (-f!l!:1ili~ jj~'I1:~. 1ii~J>$ .)/ ;1I!iil$. <p:1)-jj.'I1:~.1ii~J>$. /~;1I!iil •• ~.fj~J>$ii Methicillin-Resistant Staph,lococcus aureus (MRSA) / Vancomycin-Intetmediate / Resistant Staph,lococcus aureus (VISA/ VRSA)

<> M!Jjf~ P -~M;~.jjjUE •• Extended Spectrum Beta Lactamase (ESBL) producing organisms

<>~;1I!iil~.Jmm:.J>$. Vancomycin-Resistant Enterococcus (VRE)

<>~~1f41Ht;Jmm:;f!j! m Carbapenem-Resistant Enterobacteriaceae (CRE)

<>~~w.~~~~;f!j!./jj$~~~~;f!j!. Carbapenem-ResistantAcinetobacter (CRA) / Multi-Drug Resistant Acinetobacter (MDRA)

<> jj$.~JIl-rol¥J!. Multi-Drug Resistant Pseudomonas aeruginosa (MRPA)

---------. -it -----------' : Clinical Features ~----------- -----------

$.~.'I1:.~.~1!i"1¥:liN)i~!il!\.D~A:!lt 1: • @~ , 1::1I'~.UA1:f!RJ.5Ej].~Y.l!;!W'tffM'€t~!W m~,~~.w~,*m~.,~Q!il!\.Y.l!;~~. lfiI.'liE • ~.®A±:tE~.~~'1f~5/jil.Q~ , jlij M.~mWYl'~m· MDROs can normally be carried in asymptomatic people. However, immunocompromised or critically ill patienrs are more prone to be infected, causing pneumonia, urinary tract infection, wound infection or even bacteremia. These infections in susceptible patienrs are often more severe with limited treatment options.

TltII.it Mode-of Transmission --------------- -----------

$.~.,I1: •• .±.~~~J3€M!{!lUI ' f91J:!mJ3€M!lilil ~~m~~,~Q,*W~Y.l!;B.~.~~#Y.l!;m

m*m· I:mtt ' :lm1li!lAY.l!;mmj/,lj~'IfN.xf! ' ~.~~n'3l .$.U'I1: •• 1it~ • MDROs are transmitted by direct contact with excreta, wounds, secretions of infected patienrs or contaminated objecrs and environment surfaces. Therefore, poor personal and environmental hygiene favour transmission of these organisms.

,.--------{ Treatment ---------.lm~~~ , g~.~~f~.lIF;lfjlijJilJJil"~~~~ .M •• $f5tBi:JI~.:l!~U ' ~j{U~~~~~ ~ImJJ'3IVfi:~~M •• If it is indicated, doctors may prescribe appropriate antibiotic treatment with reference to the laboratory resulrs. Skin lesions such as boils or abscesses may require incision and drainage.