Irish MRSA rate higher due to poor resources

The number of patients who pick up MRSA in our hospitals is higher than in many northern European countries because the resources…

The number of patients who pick up MRSA in our hospitals is higher than in many northern European countries because the resources put into fighting the problem in this State are not the same as in the other countries, it was claimed at the weekend.

Dr Robert Cunney, a consultant microbiologist at the National Health Protection Surveillance Centre, said countries like Denmark and Norway had more facilities to isolate patients with infections, had less hospital overcrowding, more infection control staff, and they had aggressive screening policies and used antibiotics less.

"They decided to take MRSA very, very seriously and put the resources into it," he said.

In the Netherlands, infection rates were low and it had among the lowest levels of antibiotic use in the world.

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In this State, he said, there had to be more prudent use of antibiotics. Our use of antibiotics was on the increase, antibiotic resistance was rising and new forms of resistance were emerging.

Dr Cunney, who was speaking at the second annual conference of MRSA and Families in Waterford on Saturday, said he was "dumbstruck" recently when he received data on numbers of MRSA bloodstream infections reported by Denmark and Norway in 2005.

The number for Denmark was 11, the number for Norway, with a population of around 4.6 million, was four. In the Republic, the number of cases was close to 600.

He pointed out that these infections increase the length of time a patient has to spend in hospital and are therefore costly. While not all are preventable, many of them would be, he said.

"There is compelling evidence that if you put resources into healthcare-associated infections you actually save money and this is something we have to drive home to those who hold the purse string."

There was no national system for surveillance of healthcare-associated infections in the State even though this was a requirement under European legislation, he added. And while a recent study comparing rates of healthcare-associated infections in the Republic, Northern Ireland, Wales and the UK put the overall prevalence rate in the Republic at 4.9 per cent - which was lower than in the other three areas - he believed the rate in the Republic was "an underestimate". He was waiting to see the full data to determine if the types of hospitals and their patients had been taken into account when compiling the final figures.

Síle Creedon, a lecturer in nursing at Cork University Hospital, said a study she conducted suggested healthcare-associated infections including MRSA were costing the Irish health service at least €150 million a year.

Paul Bergervoet, an infection control practitioner at a 400-bed hospital in the Netherlands, told the conference there were now very few MRSA cases in Dutch hospitals because of a Government-backed "search and destroy" policy, which meant hospital staff actively sought out and eradicated infections.

He explained that when a patient was admitted to a hospital in the Netherlands from a hospital outside the jurisdiction, or from a pig farm or slaughter house, they were immediately isolated, and then tested for MRSA. It is only after the patient has three negative MRSA tests over a period of days that they are considered not to have the bug.

If any cases are found, even in intensive care, the whole unit would be closed, the press would be informed and all staff and patients who had come in contact with the patient would be screened.

If a member of staff was found to have MRSA on their skin after such screening they would be sent off duty and given extra training on avoiding infections.

While Dr Cunney pointed to gaps in Irish efforts to control infections like MRSA, the HSE said only last month it was committed to appointing extra infection control nurses, antibiotic liaison pharmacists and surveillance scientists. In the medium to long-term, funding would be committed to increase the number of single rooms and isolation facilities in hospitals, it added.