UK Still Has Long Way To Go In War On Killer Hospital Bugs

There is mixed good and bad news in figures for the UK released today, for while the MRSA superbug rates are falling slowly, the rate of the potentially fatal hospital bug Clostridium Difficile is still rising.

The figures released by the UK's Health Protection Agency show that the rate of MRSA bloodstream infections has declined by 5 per cent to 3,391 reported cases between April and September 2006 compared to the same period in 2005. This represents an average of 1.69 cases per 10,000 "bed days". Before the latest figures, since monitoring started in April 2001, the 10,000 bed day rate has been up and down between 1.69 and 1.88.

HPA officials are cautiously optimistic, calling the decline in MRSA cases "a plateau rather than any significant decrease, but the good news is that we can now say with confidence that reported rates are no longer rising."

In the case of Clostridium Difficile, the infection rate in patients over 65 year olds in England in the first 9 months of 2006 was 42,625 cases. This is an increase of 5.5 per cent over the same 9 months in 2005, with 40,390 cases. The HPA say that while the increase is not as big as in previous periods, it is still a high rate of infection for England, and this is particularly the case in small acute trusts.

The HPA say that while the figures show some improvement, there is still a lot of room for improvement.

The Director of the HPA's Centre for infections, Professor Peter Borriello, wanted people to remember that "the vast majority of patients do not get an infection in hospital and that not all infections are preventable. Some of these infections are the consequences of advances in medicine which now allow patients to survive, when a few years ago they were more likely to die."

He also said that the ability to monitor these mandatory figures helps to everyone to keep an eye on important information in a "timely manner". He said that " the results will play a vital role in helping hospitals measure their success in trying to reduce these infections."

Clostridium Difficile

Clostridium Difficile is not a superbug but a common gut-living bacteria found in healthy people. It can be treated quite easily. 66 per cent of healthy babies have it and 3 per cent of healthy adults have it.

C difficile does not normally become a problem unless the balance of gut bacteria is upset by illness, or also by treatments such as antibiotics. Symptoms range from nothing at all to very bad diarrhea, and in a few cases it can lead to potentially fatal bowel inflammations.

Unfortunately, because the symptoms for many people are quite mild, C difficile infections can pass unnoticed and untreated. Hospital environments are favourable breeding grounds because they have large groups of people in close proximity, and who may well be in a vulnerable state with compromised immune systems or receiving antibiotic treatments.

MRSA - Methicillin-Resistant Staphylococcus Aureus

MRSA is a superbug because it is drug resistant. MRSA stands for Methicillin-Resistant Staphylococcus Aureus, a strain of one of the most common bacteria, that has developed resistance to one or more antibiotics, particularly those like penicillin.

Nearly everyone carries Staphylococcus Aureus on their skin, in their nasal passages, in their respiratory tract. But in healthy people the potential for it to form a critical mass and invade the body through open wounds is kept in check by the immune system. It is when the body becomes vulnerable in some way that the balance becomes distorted in favour of the bug. In more recent decades, due to stronger and more frequent use of antibiotics, the drug resistant strains gain a hold quickly and pass to others more easily.

Most commonly associated with hospitals, because these environments give it the best breeding conditions if unchecked, a new MRSA strain known as community acquired MRSA (CA-MRSA) has also been found in locker rooms in sports centres and in child day care centres in the US and Australia. There have even been cases of it in originating in unlicensed tattoo parlours.

MRSA infections cause anything from a mild irritation, for instance near an open sore or scratch, to boils, and in extreme cases it can develop into necrotizing fasciitis, or flesh-eating disease.

The best way to protect against infection by either bug is to be scrupulous about hygiene to remove the opportunity for passing from person to person, and to remove sites where the germs can lie dormant, waiting for the next vulnerable "host" to come along.

Bugs in the home

According to the self-help blog maintained by survivors and carers of people who have or have had MRSA, the six places in the home that are most likely sources of MRSA and superbugs are:

- Kitchen sponges and dishcloths
- Cutting boards
- Kitchen surfaces and faucet/tap handles
- Sink drains
- Knobs and handles (cupboards, doors)
- Toothbrushes

Health Protection Agency (UK).

MRSA Notes (Forum and blog maintained by carers and survivors).

Written by: Catharine Paddock
Writer: Medical News Today