Rarely a day goes by without another headline about hospital 'super-bugs' - and more specifically MRSA - but what exactly is MRSA? Where did it come from, what are MRSA symptoms and why is MRSA so difficult to treat?
This article on MRSA symptoms and treatment is written by Sarah Dawson, a freelance journalist who writes for national and international newspapers, magazines and websites.
MRSA stands for methicillin-resistant staphylococcus aureus and is a form of bacteria from the Staphylococcus aureus (SA) germ family. It is a hospital acquired infection (HAI), known as a 'superbug', and it's currently wreaking havoc in our health services.
Depressingly, we have one of the worst MRSA records in Europe. Some of our neighbouring countries have almost non-existent infection levels and it's thought that this is down to having more isolation facilities and lower bed occupancy.
SA bacteria actually live on the skin's surface or inside the nose of around thirty percent of us - without causing any harm. People carrying the SA bacteria are 'colonised', not 'infected', because the bacteria are merely on the surface of the body, not inside harming tissues or blood. However, if SA germs get into the body via cuts or wounds they can cause a skin infection like a boil or abscess, or in more serious cases if bacteria enter the bloodstream through a wound they can cause blood poisoning (septicaemia), heart-valve infection (endocarditis), urinary tract infection or pneumonia.
In an attempt to meet increasing targets and slash waiting lists there is a very high turnover of patients and high bed occupancy in our hospitals today. Short staffing leads to employing temporary staff who may not be as well briefed on infection control and consequently, a patient's bed and surrounding area may not be thoroughly sterilised, or vacant long enough for proper cleaning because staff are too busy dealing with a stream of emergency admittances. The media calls this "hot bedding".
MRSA can enter the body via wounds, surgical scars, and through the use of equipment such as intravenous drips. The bacteria can also be spread from one wound to another and in overcrowded hospital wards the bug can unwittingly be transferred from patient to patient by hospital staff.
Staying for a long time in a hospital environment makes patients more vulnerable to picking up an SA infection. Elderly patients, those with weakened immune systems, in intensive care or undergoing cancer chemotherapy as well as newborn or premature babies are most vulnerable to MRSA infections in hospital, but MRSA rarely causes problems for fit and healthy people.
It used to be possible to treat SA infections with antibiotics similar to Methicillin. This was developed from the antibiotic, Penicillin, to treat SA infections when the bacteria had evolved and Penicillin was no longer strong enough to treat it. However, over the past 50 years or so certain types of SA have developed into 'super-strains' which don't respond to methicillin or other antibiotics.
Health experts believe that most SA strains can be treated with methicillin-type antibiotics through injection or intravenous drip, however the strains of bacteria which are resistant to methicillin (and other antibiotics) account for over 40 percent of SA infections in England and official figures show that about 15% of reported cases of contracted MRSA result in death.
With the constant barrage of media attention about MRSA and hospital acquired infections, there is little wonder that so many people are turning towards private care, and the PMI industry is enjoying an enormous boost. There's no doubt about it, treatment in a private hospital or clinic will significantly reduce your chance of contracting a hospital acquired infection. Here's why: independent hospitals have lower bed occupancy, nursing staff are under less pressure and patients mostly have their own private rooms with en-suite bathrooms lowering the risk of cross-infection. Furthermore, a higher nurse-to-patient ratio ensures a higher quality of care, and with more money and more staff resources private hospitals can operate a robust infection surveillance programme and ongoing staff training to minimise infections and carry out isolation procedures if a patient is an MRSA carrier.
But if you can't afford to go private, what's the solution?
Rates in the UK
Reassuring news is that rates of MRSA infection are now dropping. Figures in July 2007 from the Health Protection Agency show that the number of cases of methicillin-resistant Staphylococcus aureus (MRSA) infections of the blood fell in January to March 2007 compared with the previous quarter. There were 1,444 cases of MRSA infections of the blood reported in England in January to March, compared with 1,542 in the previous quarter. Despite appearing otherwise, the government is trying to reduce the spread of MRSA. All NHS hospitals must have serious measures in place to reduce the spread of infections like MRSA, such as increased hand-washing by doctors and nurses, the use of alcohol-based hand rubs between patients to avoid transferring bacteria between patients, and thorough cleaning in hospital wards, corridors and surfaces.
The Department of Health has an MRSA/Cleaner Hospitals programme to support organisations and individuals in reducing healthcare associated infections with a Clean Safe Care web resource for healthcare staff. Equally, the Health Care Commission (HCC) is doing unannounced inspections to 120 NHS trusts to check their compliance. And to keep on track on figures, the HPA (Health Protection Agency) is publishing quarterly figures for the mandatory surveillance of MRSA bloodstream infections along with an annual Healthcare Associated Infection report.
Advice for patients
Generally speaking, healthy people are at a low risk of contracting a HAI like MRSA, including pregnant women and children, but if you are going into hospital you can take some measures. Firstly, make sure you go to a hospital with a low MRSA infection rate. Patient Choice launched in December 2005 and means that you can choose one out of four or five hospitals (including NHS Trusts, Foundations and treatment centres) in which to be treated.
Before going into hospital, start using a bactericidal soap and shampoo and continue while there, always washing or cleaning your hands after visits to the bathroom and before/after meals and wearing shoes or slippers when walking around. Insist that the area around your hospital bed is cleaned if it looks unclean and ask the medical staff whether they have washed their hands before touching you. Ultimately, MRSA is no more infectious than other SA infections, but good hygiene is essential to prevent it spreading.