In July one of the first acts of Gordon Brown as Britain’s new prime minister was to declare war on hospital-acquired infections, and on so-called superbugs in particular. On the same day, a notorious superbug – Methicillin-Resistant Staphylococcus aureus, or MRSA – made the headlines in Australia and the United States. The triple dose of MRSA news could prompt a wider war on the problem, which is largely preventable.
Superbugs are microorganisms that have become resistant to antibiotics, a problem generally blamed on overuse of the drugs. About a third of the superbugs are Methicillin-resistant Staphylococcus aureus, which is often undetected in carriers because they can be symptom-free. It flourishes in hospitals and lies in wait for patients with weakened immune systems. Easily transmitted by touch, the bacteria can infect surgical incisions, open wounds such as bedsores, or enter the body via urinary catheters and similar equipment.
According to Britain’s Observer newspaper, the Prime Minister Brown is masterminding a battle to slash the rates of MRSA and other hospital infections. Since MRSA first hit British hospitals 10 years ago, it has spread across the country, as an increasing number of people became resistant to antibiotics, coupled with poor cleaning on the wards and the fast turnover of patients.
A new survey of US healthcare facilities suggests that nearly 5 percent of patients carry MRSA, putting the national prevalence at between 8 and 11 times more than previous estimates. The authors of the survey, the Association for Professionals in Infection Control and Epidemiology (APIC), describe it as the "largest and most comprehensive MRSA study of its kind." According to the US publication Medical News Today, over 1,200 facilities provided data for the survey, which the researchers say is a statistically relevant sample because it represents about 21 per cent of all US healthcare facilities and 28 per cent of the average daily census.
In the headlines from Australia, disease experts warned in the Medical Journal of Australia (MJA) that the country’s hospitals are failing to cope with antibiotic-resistant infections and little is being done to address the problem. The director of the Infectious Diseases Unit and Microbiology at the Canberra Hospital, Professor Peter Collignon, said superbugs are a serious and growing problem. "We should be concerned, I mean there’s at least probably a couple of thousand people per year who have MRSA in their bloodstream," he told television network ABC in Australia, which reported the MJA article. "We know a third of those die within 30 days, and I would think at least half of those infections are likely to be preventable." He sees too little being done to combat the problem. In order to reduce the prevalence of superbugs, health professionals need to follow basic infection control practices, according to the professor. He suggests hospitals need to be better designed to allow more quarantined single rooms for infected patients.
In The Netherlands, Denmark and Finland – among several European Union countries that have reduced or eliminated these infections – control hinges on ergonomic search and destroy practices. As described in an October 2006 article in Slate magazine, the measures start with considering new patients as biohazards. They are placed into quarantine while it is determined if they are carrying MRSA or similar threats. If the patient tests positive, hospital workers will don protective gloves, masks, and gowns each time they approach the person, then strip off the gear and scrub down vigorously when they leave the room.
Interviewed by The Ergonomics Report™, Betsy McCaughey, Ph.D., an ex-lieutenant governor of New York and founder of the Committee to Reduce Infection Deaths (RID), explained that the most effective preventative measures are “hand hygiene, careful cleaning of equipment in between patient use, screening patients on the way in to identify those carrying the dangerous bacteria on their skin or in their nasal passages, and then taking the proper barrier precautions to prevent these bugs from being transmitted to all the other patients in the hospital on stethoscopes, blood pressure cuffs, on lab coats, and nurses uniforms, and bedrails and wheelchairs, etc.”
She was asked why hospital infection remains a scourge when it is proven to be preventable. “We have the science to prevent this problem,” she replied. “What is lacking is the will to do it.”
Sources: The Observer; Medical News Today; ABC (Australia); Slate; The Ergonomics Report™
