Monday, April 03, 2006

What is MRSA? How does it affect me?

Last updated:Wednesday 11 August 2004
1. What is MRSA? 2. How does it affect me? 3. Why is it a problem in UK hospitals?4. What can I do to improve things? 5. What if I have MRSA myself? 6. How do we compare with Europe? 1. What is MRSA? MRSA is a bacteria which causes infections. (MRSA is short for Methicillin-Resistant Staphylococcus Aureus or Multiple antibiotic-Resistant Staphylococcus Aureus.) It has become known as a ‘superbug’ because it has developed resistance to several antibiotics. Antibiotics aren't completely powerless against it, but much higher doses over much longer periods may be required. MRSA is one of many infections often picked up in hospitals, as people are at risk when their defences are low. MRSA can exist on many healthy people’s skin without them even knowing it. But for people suffering from other conditions an MRSA infection can lead to death. Hospital-acquired infections lead to approximately 5,000 deaths every year, according to National Audit Office report from July 2004. Data from the government and the Health Protection Agency shows that between April 2003 and March 2004 MRSA infections in England alone increased by 3.6% from 7,384 to 7,647.For more information on MRSA and its resistance to antibiotics, see the Q&A: MRSA ‘superbugs’.
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2. How does it affect me?As a UK tax-payer: hospital-acquired infections such as MRSA cost the NHS about £1bn per year. As a patient: you may be at risk of infection if you attend a hospital with a high incidence of MRSA. The Department of Health in England has statistics for each NHS hospital’s incidence of MRSA, calculated by how many patients catch MRSA for every night spent by a patient in a hospital bed. Guy's & St Thomas's NHS Trust in London, a specialist hospital, had the highest MRSA rate at 0.45 cases per 1,000 overnight stays. Hereford Hospital had the lowest rate of MRSA at 0.04 cases.See how your local hospital faresIn England, see the document linked to the Department of Health’s website. For hospitals in Scotland, see the report by the Scottish Centre for Infection and Environmental Health. For hospitals in Wales, see reports published by the Welsh Healthcare-Associated Infection Programme (WHAIP). Statistics on MRSA in Northern Ireland hospitals are available from the Communicable Disease Surveillance Centre.
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3. Why is it a problem in UK hospitals? Experts are divided over why MRSA has become so widespread in UK hospitals, in comparison with the rest of Europe (see section five). "Complacency, poor prescribing practice and misuse of antibiotics has led to the emergence of drug resistant infections", according to a report in 2000 by the UK Parliament. Fewer empty beds and high throughputs of patients prevent MRSA and other hospital-acquired infections being tackled effectively, according to the latest report by the National Audit Office. Hospital-acquired infections can be reduced by strict hospital hygeine, frequent handwashing and a greater proportion of single rooms. Tough measures against MRSA require less overcrowding, more empty beds and isolation wards to absorb the disruption of isolating the infection.But, according to the National Audit Office report, there are wider factors in the UK which make it difficult to take necessary steps to prevent and control hospital infections. For example, government targets have led to higher bed occupancy, while staff shortages and the increased use of unqualified staff have compromised strict hygeine practices. In addition, there is the increasing problem of bacteria strains resistant to antibiotics.
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4. What can I do to improve the situation?
A high MRSA rate at Guy's & St Thomas's
Be an active patientIn England, the Department of Health is encouraging patients to
“demand the highest standards of hygiene and –since human contact is a major way infection spreads in hospital - to feel happy to ask staff if they’ve washed their hands.” In future there may be more opportunities for you as a patient to contact hospital cleaning services directly with new bedside phones.MRSA Support, a group supporting and representing MRSA sufferers, has a list of Do's and Don'ts while you're in hospital.Stay informed The government has suggested every hospital in England will have to publish and display hospital-acquired infection rates and trends. As a patient you may have a choice of hospitals by the end of next year and this information could become a factor in your decision. For advice and information on cleanliness in English hospitals, contact your local hospital’s patient advice and liaison service(Pals). Get involvedThis is an opportunity for you to raise your concerns, hold your hospital to account and help them improve cleanliness. Patients’ forums in England will be conducting cleanliness inspections of hospitals in their area four times a year. See the iCan guide on How you can get involved in improving NHS services in England. In Scotland, contact your local health board.See the iCan guide on How you can get involved in improving NHS services in Scotland. There is also a separate Hospital-Acquired Infection (HAI) Taskforce which includes patient representatives.In Wales, contact your local health board or Community Health Council for more information on hospital-acquired infections and ways you can get involved to help standards improve.Contact your political representativeIf you have concerns about cleanliness standards in hospitals, MRSA or any other hospital-acquired infection in England, you can raise them with your MP, MSP or Welsh Assembly Member. Simply enter your postcode for England, Scotland, or Wales to see your local representative’s contact details.You can also find out what MPs have been saying about MRSA in the UK Parliament recently.Contact interested organisationsThe Patients Association is campaigning for clean and healthy environments in hospitals. See their website to find out more and share your experiences at your local hospital.
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5. What if I have MRSA myself? If you are concerned about your health, you should seek medical advice. NHS directhas information and advice about MRSA and the Health Protection Agency has published a leaflet for patients.
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6. How do we compare with Europe? UK levels of MRSA bloodstream infections are amongst the highest in Europe, according to government data.The Department of Health reported an 8% increase in overall Staphylococcus aureus bloodstream infections, from 17,933 (2001/2002) to 19,311 (2003/2004). Of these, around 40% are MRSA - making the UK’s rate among the worst in Europe.Levels of MRSA as a proportion of all bloodstream infections in other European countries, according to European Antimicrobial Resistance Surveillance Systems data for 2002, are:Denmark 1%Netherlands 1%Austria 11%Germany 19%Spain 23%France 33%Portugal 38%Italy 38%Greece 44%UK 44%(Note: figures vary slightly because of differences in research techniques, but the general conclusions are similar.)What are these countries doing to combat MRSA and healthcare-associated infection? Some countries, such as the Netherlands and Denmark, have been successful in controlling MRSA.The Dutch have adopted a policy, known as ‘search and destroy’. This involves screening patients for MRSA and isolating those found to be infected. The Dutch have also set aside a number of single rooms in hospitals to treat those with MRSA, plus there is a higher number of healthcare workers to every patient. Most countries are adopting similar strategies to control MRSA. These include:
Majoring on clean hospital environments and good hygiene
Isolating infected patients
Developing systems to detect MRSA For more information on international health comparisons,
read the National Audit Office’s research on MRSA. There is also more information on international health comparisons in the Department Of Health report, Winning Ways .

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