Getting ill in Hospitals

[ray]

A friend of mine has gone in Hospital and he has caught the MRSA bug, he went in for an operation, but now feels more sick than he did a weeks ago.
Is that bug only getting in our UK Hospitals or is it world-wide?

[David Webb]

.US doctors warn of small but alarming rates of a flesh-eating type of superbug.

Patients appear to have caught the MRSA infection that attacks the skin outside of hospital, reports the New England Journal of Medicine.

At a centre in California, 14 patients were identified between 2003 and 2004, and some needed to be hospitalised.

So far no cases have been seen in the UK, but health officials said they were monitoring the situation.

[patsy]

The infections in the US community have typically manifested as skin infections, such as pimples and boils, in otherwise healthy people.

Although none of the 14 patients died, they had serious complications, including the need for reconstructive surgery and prolonged stay in the intensive care unit.

The disease is different to MRSA infections seen in the UK, which occur most frequently among people in hospitals who have weakened immune systems.

The CDC has been investigating clusters of the community-acquired MRSA skin infections among athletes, military recruits and prisoners.

Spreading

A common theme associated with the spread of these MRSA skin infections appears to be close skin-to-skin contact, openings in the skin such as cuts or abrasions, contaminated items and surfaces, crowded living conditions and poor hygiene.

The CDC is investigating why this strain is particularly good at spreading.

The study authors, from the University of California, Los Angeles, said: "We have recently noted an alarming number of these infections caused by community-associated methicillin-resistant Staphylococcus aureus (MRSA)."

They recommended that in areas in which the infection is endemic, suspected cases should be promptly treated with antibiotics.

In the UK, there have been some cases of MRSA in the community, but experts say these are different to the cases arising in the US.

Angela Kearns, head of the Health Protection Agency's staphylococcus reference laboratory, said: "Over the past three years the Agency has seen only a small number of community-acquired MRSA cases, and the UK hasn't seen the levels of true community MRSA that have been seen in the States.

"Consequently, the risk of contracting this type of MRSA in the UK remains extremely small."

[Dr Sheppard]

A new medical centre is being set up in Coventry to conduct research into diseases such as MRSA.

The Medical Research Fund Coventry and Warwickshire is being set up by experts at Warwick University.

The number of MRSA superbug cases is at its lowest level in English NHS hospitals since mandatory records began in 2001, says the government.

It said there were 6% fewer cases between April and September last year than in the same period in 2003.

Treat 'rapidly'

Professor of Microbiology at Warwick University, Chris Dowson, said: "We can bring together some of the really innovative tools to help the diagnosis of infections such as MRSA.

"So perhaps rather than having to wait two hours, which might be the waiting time for some of the new tools that might become available, we might be able to do this in seconds.

"So patients might be screened the instant they walk into hospital.

"Hospital-acquired infections change with medical practices.

"Certainly hygiene is important but hand washing alone is not going to solve the problem.

"We need to implement appropriate use of antibiotics and appropriate diagnostic tools so we can identify, isolate and treat these organisms as rapidly as possible."

[Karen]

What is MRSA?

The term MRSA or methicillin resistant Staphylococcus aureus is used to describe an organism that is resistant to commonly used antibiotics. If the organism is on the skin then it can be passed around by physical contact. If the organism is in the nose or is associated with the lungs rather than the skin then it may be passed around by droplet spread from the mouth and nose.

We can find out if and where MRSA is located by taking various swabs from a person and carrying out tests to decide how sensitive the organism is to antibiotics and if it is a methicillin resistant (MRSA) organism. These test usually take 2-3 days.
Can MRSA Be Treated?

Due to the overuse of antibiotics over many years this bacteria has evolved to be resistant to Methicillin - which is a benchmark antibiotic. This was never actually used in its original form.

Its equivalent in use today is Oxacillin. Antibiotics which will deal effectively with this bug are now limited, research continues looking for an antibiotic that can fight this bug.
Who Can Get MRSA?

MRSA does not respect age. A new born baby had become infected with it from the umbilical cord when it was cut. MRSA infections most often occur in patients in hospitals and are rarely seen among the general public. As with ordinary strains of Staphylococcus aureus, some patients harbour MRSA on their skin or nose without harm (such patients are said to be 'colonised'), whereas other patients may develop infections.

Some patients are at increased risk of developing infection. They include those with breaks in their skin due to wounds (including those caused by surgery), indwelling catheters or burns, and those with certain types of deficiency in their immune system, such as low numbers of white cells in their blood.
How do we prevent the spread of MRSA ?

Measures to prevent the spread of organisms from one person to another are called infection control. The spread of MRSA can be greatly reduced by caring for someone in isolation. Another major factor in the spread of MRSA is hand washing. Hand washing will reduce the rate of transmission by one third or 33%.
DO’S AND DON’T’S IN HOSPITAL

DO

* If there is dust or dirt around or under your bed, ask for the area to be cleaned.
* Wash with bactericidal before visiting, or admission to, hospital.
* Watch the staff with regard to yourself especially hand washing.
* Ensure that toilets are clean before using them.

DON'T

* Get too close to other patients.
* "Put up" with soreness or discomfort.
* Use tissues more than once.

Do Healthcare workers wash their hands?

A recent study showed that healthcare workers only washed their hands at a rate of 51%. However, very real reasons exist for this low rate such as busyness and provision of hand washing agents that cause redness and irritation to the skin. When a convenient, user friendly, effective hand washing agent was provided, compliance rose to 83%.

We need to address this issue nationally and decide on a hand washing agent that is microbiologically effective, kind to skin and convenient to use. This will have an immediate knock on effect on the rate of bugs such as MRSA being transferred from one person to another.

[Susan]

The Centers for Disease Control and Prevention (CDC) hosted today an important clinician update about community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA). School closures and student deaths due to the so called Superbug are dominating the news. How do we protect our loved ones and ourselves?

The main thing the CDC wants us to be aware of is that 80% of these infections are skin infections. Staphylococcus aureus is a very common organism - 60% of us have it in our nose right now. Otherwise healthy people are getting extremely sick due to this infection as it becomes invasive. Why?

The infection presents as a common skin infection. It looks like a skin abscess or is commonly mistaken for a spider bite. It starts as a painful red bump that becomes necrotic (tissue dies). Clinicians assessing it may mistake it for a furuncle, boil or abscess. In newborns it may appear a breakdown of the skin under the diaper. MRSA now belongs in the differential diagnosis of every soft tissue infection. It is one of the most common causes of osteomyelitis after it becomes invasive.

MRSA infection will need to be treated with incision and drainage and antibiotics. If severe and recurrent, the infection will need to be treated aggressively with IV antibiotics and hospitalization.

Risk factors in the community are:

* Crowded living conditions (military barracks, boarding school)
* Frequent skin to skin contact (e.g. football)
* Compromised skin surfaces (e.g. turf burns - football)
* Sharing contaminated items (e.g. towels - football)

Prevention tactics:

* Good personal hygiene and cleanliness
* Keep all cuts and scrapes clean and covered
* Clean all common surfaces with commercially available disinfectants
* Alcohol based hand sanitizers are as effective as hand washing for MRSA per CDC
* Shower immediately after contact sports
* Wear uniforms and practice clothes only one time
* Wash uniforms and practice clothes in hot water and soap
* Do not share soap, towels, deodorant or razors
* Clean and disinfect athletic gear, equipment and gym areas
* Report any infections to school nurse and coach
* Avoid contact with other people's infections

[Ricky]

British Scientists Fight Killer MRSA Bug

11:32am UK, Sunday May 18, 2008
A new drug to kill off the fatal hospital bug MRSA is being tested by British scientists and they hope it will ready for patients within three years.

180 MRSA bacteria

'Potential is really quite amazing'

Most antibiotics used to treat hospital bugs such as MRSA are bacteriostatic, meaning they prevent the growth of bacteria.

But pharmaceutical company Destiny Pharma believes its compound - codenamed XF-73 - could hold the key to stamping out the potentially-fatal bug.

A study showed that, even after 55 repeat exposures, MRSA bacteria did not develop resistance to the drug - which is applied as a gel into patients' noses - in the same way it does to antibiotics.

The research was led by Destiny Pharma's chief executive Dr Bill Love: "If it goes through clinical trials successfully, it really is a completely fundamental breakthrough," he told the Independent on Sunday.

"The potential is really quite amazing."

He said he hoped NHS strategic health authorities, responsible for spending money on treatment and deep cleans, would be willing to pay for XF-73 if it was approved by the National Institute for Clinical Excellence.

The firm presented its findings to the European Congress on Clinical Microbiology and Infectious Diseases in Barcelona last month.

XF-73 destroyed the five most common strains of methicillin-resistant Staphylococcus aureus bacteria (MRSA) in laboratory tests, according to the study.

Five of the most common strains of MRSA were tested against the drug and an antibiotic was used as a control.

Derek Butler, chairman of the campaign group MRSA Action, cautiously welcomed the development and called on the Government to provide more funding for research into reducing infections.

He said: "We need to be careful in saying we have beaten the resistance problem. Bacteria have a habit of being able to get round any treatments we develop.

"But it is a good move and we are very hopeful."

Last September, the Prime Minister announced that every NHS hospital in England would be deep-cleaned in a bid to tackle bugs such as MRSA and Clostridium difficile.

[Diane]

Mozart probably died of a flesh-eating hospital bug similar to MRSA, say scientists.

The composer's death at 35 in 1791 sparked rumours that he may have been poisoned.

But Dutch researchers say it is much more likely he contracted a virus while being cared for.

They studied medical records from Vienna at the time and concluded he had dropsy. That was a common illness those days - and he may have caught it from an epidemic that began at an army hospital with poor hygiene.

Days before he died, Mozart's sister-in-law Sophie Haibel said he was covered in a rash and barely able to move.

Expert Dr Richard Zeger said: "I think you can compare this to a superbug like MRSA or C-Diff.

"We still see the streptococcal infection today in close communities like schools and the armed forces so that would be a good reason behind the way it spread.

"There was clearly an epidemic at that time and we found that it started in a military hospital." Dr Zeger, whose report will appear in the Annals of Internal Medicine, added: "The army had several soldiers who were also top musicians. And they could have performed in Vienna, where Mozart might have contracted the bug."

Records show more than 500 people died of a similar illness in the months around Mozart's death.

[Nick]

AN Irvine man who contracted MRSA said he was left in agony for six weeks by doctors - wondering if his leg would have to be cut off. Robert Reid, 56, eventually had to have a large chunk of his thigh removed in an operation to stop the superbug. He said: “I’ve never felt pain like that in my life. It’s hard not to be bitter.” The Broomlands grandfather of four claimed he contracted MRSA during a straightforward absece operation at Crosshill Hospital. And he said a run of medical mistakes meant he had to go back four times over two years before the damaging disease was stopped. Only when most of his leg was ravaged with holes, he said, did doctors admit that his antibiotics weren’t working.