MRSA

(ON THE 5^th DECEMBER 2003 THE DEPARTMENT OF HEALTH ISSUED A DOCUMENT ON MRSA. THIS INCLUDES COMPARATIVE DATA. THE MATTER HAS BEEN HIGHLIGHED IN A RECENT CHANNEL 4 PROGRAMME)

The Government has announced new rules to prevent MRSA infections. Under the plans every hospital in England will get a new director of infection control. Currently about 5000 people die of MRSA infection every year.

The Government wants to put an end to \"filthy hospitals\" where bacteria breeds. This problem has been highlighted by Channel 4 who filmed extraordinary squalor in some of the very places where hygiene should be paramount.

Many of Britains medical staff appear to have forgotten the necessary procedures for keeping infection at bay such as washing their hands between patients. Add to this is the over-reliance on antibiotics and the contracting out of NHS cleaning services.

Results of a 2-year survey by the Department of Health of MRSA in Acute Trusts in England April 2001 to March 2003

The total number of MRSA bacteraemia cases over the 2 years was 7281 and 7384. The overall bacteraemia rate was 0.17 per 1000 bed days.

In interpreting the data the following need to be born in mind:

a) The figures reflect the burden of serious infection associated with MRSA (bacteraemia or blood steam infection) and not all MRSA infection or carriage.

b) The MRSA bacteraemia infections reported were not necessarily acquired in that particular Trust. There is much patient transfer between hospitals.

c) Some Trusts have a high preponderance of units with more patients who are vulnerable to MRSA such as specialist surgical units. They are quite likely to experience a higher rate than a Trust that has a high proportion of lower risk units (eg. maternity or paediatric wards).

For the purposes of this study hospitals were divided into 3 groups general acute, single speciality and specialist hospitals. Both the North Bristol NHS Trusts and the United Bristol Health Care Trust categorised in the specialist group (containing 46 Trusts). The North Bristol NHS Trust MRSA rate per 1000 bed days was 0.20. The equivalent figure for the UBHT was 0.37. Three Trusts in this group achieved worse scores than the UBHT.

RLH