Posted on 04/22/2005 5:23:47 PM PDT by neverdem
Filed at 3:01 p.m. ET
LONDON (AP) -- It's immune to most antibiotics and has killed hundreds of patients in hospitals across Britain. Now, a superbug has found its way into the British election campaign, with Tony Blair's government promising to slash infection rates.
For the leader of the opposition Conservatives, Michael Howard, the debate is particularly personal: His mother-in-law died of the infection.
''I mean, how hard is it to keep a hospital clean?'' reads a Conservative billboard.
Britain has the second-worst record in Europe for methicillin-resistant staphylococcus aureus, known as MRSA, a bacteria that can kill through blood poisoning and affects hospitals across the developed world.
''Today, when someone in your family gets sick, the worry is made 10 times worse because of Britain's dirty hospitals,'' Howard said in a speech ahead of the May 5 parliamentary vote.
But Blair's camp says the problem started under Conservative governments between 1990 and 1997.
''The Tories failed to tackle MRSA while in office. The Tories' only idea for tackling MRSA, allowing nurses to shut wards, has been slammed by nurses themselves,'' said Health Secretary John Reid. ''You cannot tackle the superbug with a soundbite.''
The NHS Confederation, representing the trusts that operate hospitals, was provoked to dispute Conservative claims. The confederation noted the Conservatives claimed 247 patients had been infected in one constituency. The actual number, the confederation said, was six.
Medical experts believe both sides are guilty of oversimplification. Some say eradicating the bug is already a losing battle.
''Ha, ha, ha,'' said Dr. Henry Chambers, chief of infectious diseases at San Francisco General Hospital when told of an election promise by Blair's Labour Party to halve infection rates by 2008.
''No way. Halving the MRSA rate is illusory. It's a fantasy,'' he said.
He's equally dismissive of the Conservatives' reliance on a chief nurse to oversee hygiene and upgrade cleaning standards.
''You can maybe slow it, maybe change the rate a little teeny bit and affect the level at any given period of time, but ultimately I think the organisms are so well established that there's not very much that can be done from the dirty hospital point of view,'' said Chambers, an expert on MRSA.
MRSA is a toughened variety of its parent, staphylococcus aureus, or staph, which is carried in the nostrils and on the skin of about 40 percent of the population and is a common cause of infections. MRSA is immune to many conventional antibiotics that are successful against general staph.
Like other bacteria, MRSA usually gets into the blood through a wound from surgery or from a tube inserted into the bloodstream to deliver nutrition or drugs. However, its fatality rates are no greater than regular staph, experts say.
Britain has the second-highest prevalence of MRSA in Europe, after Greece. About 46 percent of all staph infections acquired in British hospitals are MRSA. Scandinavia and the Netherlands have the lowest MRSA rates, at less than 2 percent.
Of about 11 million hospital admissions in Britain in 2003, 7,683 patients contracted MRSA; 321 of those patients died of MRSA.
Surveys indicate the problems is even worse in the United States, where 56 percent of all hospital-acquired staph infections in 2004 were MRSA.
''It is a function of the fact that hospitals are where sick people are and where antibiotics are used,'' Chambers said. The use of antibiotics helps speed the ability of germs to mutate for self-preservation.
Hospitals are also treating older and sicker people these days and performing more adventurous surgery and treatments that require more tubes to be inserted into the body. All of that presents opportunities for MRSA.
''Nothing has stopped the march of these organisms and once they get into the community -- and they already have -- any hope of containing them is gone,'' Chambers said.
Some experts believe strict infection control measures, such as nurses washing their hands between every patient contact and isolating infected patients, can help substantially. They agree that having head nurses police cleaning staff would not have any direct impact.
Hand-washing is at the top of the list of prevention measures. But even that isn't an easy fix.
''A nurse might have 100 times a day where she has to wash her hands. The alcohol gel is an irritant. It dries out the hands, and dry irritated hands are more easily colonized with MRSA,'' said Dr. Mark Enright, an MRSA specialist at Bath University in England. ''It's a very complex, interrelated set of things.''
Another important factor is the number of patients in British hospitals.
''Relative to other countries, there's very high bed occupancy -- approaching 100 percent. In the Netherlands, the bed occupancy is about 60 percent, which makes it easier to isolate someone with MRSA,'' Enright said.
We're there already. That doesn't mean MRSA can be ignored. Lousy prescribing and the hospital environment have their costs.
Vancomycin intermediate and resistant Staphylococcus aureus. What the nephrologist needs to know.
IIRC, illegal immigration has played its part too, via loose use of antibiotics in Mexico and Central America (although that would have less to do with vanco). It's hard to blame the individual doc for undue caution in this legal environment, but sloppy hospital management has less excuse.
Chicago Tribune, 'Infection epidemic carves deadly path' - July 21, 2002.
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