Hospital superbugs
Monday, 03 Mar 2008 17:20
NHS wards are facing a crack-down on healthcare-associated infections
An explanation of the widely-used term 'hospital superbugs' and an overview of steps taken to reduce them.
What are hospital superbugs?
The term 'hospital superbugs' is sometimes used to refer to the healthcare-associated infections (HCAIs) MRSA and Clostridium difficile (C.difficile). HCAIs can be caught by patients during a hospital stay.
MRSA and C. difficile have hit the headlines in the past year as hospital trusts have worked to reduce infection rates and opposition parties accused the government of failing to ensure clean hospitals.
MRSA (methicillin-resistant Staphylococcus aureus) bacteria are resistant to methicillin, a type of penicillin, and to some other antibiotics. This makes them hard to treat and often results in antibiotics being given at a higher dose over a much longer period.
C. difficile is a bacteria that does not usually affect healthy children and adults as healthy 'good' bacteria can keep it in check in the large intestine.
But some antibiotics can interfere with this balance and C. difficile can multiple and produce toxins, leading to an infection.
Once they have left the body spores from the infection can contaminate their surroundings and can survive for a long time unless they are destroyed by thorough cleaning.
Older people; those who have been treated with broad spectrum antibiotics; people with a weakened immune system; and people having to stay for a long time in a healthcare setting are most vulnerable to a C. difficile infection.
Key statistics
Latest figures from the Health Protection Agency (HPA) show that there were 1,072 cases of MRSA reported in England during the July to September quarter of 2007.
This represents an 18 per cent decrease on the previous quarter (April to June) when 1,304 reports were received.
There were 10,734 C. difficile cases in patients aged 65 years and over in England reported in the third quarter of 2007 (July to September).
This is a 21 per cent decrease on the previous quarter, when 13,669 reports were received, and a reduction of 2,087 cases (16 per cent) on the same period last year.
Campaigns
The government has described HCAIs as a "serious concern" and has announced a number of headline-grabbing ideas to target them. These include a 'deep-clean' of every hospital by the spring of 2008 and a ban on doctors' long-sleeved white coats and wrist watches.
In 2004 the then health secretary John Reid announced the Towards Cleaner Hospitals strategy to lower rates but by 2007 it became clear new steps were also needed.
In June a report from the Healthcare Commission found that a quarter of NHS trusts were failing to meet government targets to reduce HCAIs. The watchdog's chief executive Anna Walker said it would use its powers to tackle non-compliance with cleanliness standards.
And in October health secretary Alan Johnson announced the creation of the Care Quality Commission (CQC), a new regulator designed to control infections in the NHS.
The CQC will work to strengthen the existing monitoring systems in UK hospitals and will have the power to carry out annual infection control inspections at all hospitals.
Quotes
"We will not hesitate to use our powers under the hygiene code or through investigations to require trusts to make immediate improvements in their infection control practices if necessary.
"There is no silver bullet for healthcare-associated infections. It requires action across all of these areas and relentless attention to good practice for every patient every time."
Healthcare Commission chief executive Anna Walker
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"Safety is my top priority. That means everyone in the NHS doing much more than in the past to get the basics right - washing hands, cleaner hospitals [and] more effective infection prevention."
Health secretary Alan Johnson
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"Patients have a right to expect the highest level of hygiene in the NHS and to have stringent systems in place to prevent infections from spreading.
"Only a co-ordinated approach addressing all the relevant factors, for example high rates of bed occupancy, inadequate staffing levels, effective cleaning regimes and isolation policies, is likely to be successful,"
British Medical Association chairman Dr Hamish Meldrum