Hospitals Fail To Report Spread Of New Superbug 'More Dangerous Than MRSA'

Beezy Marsh, Health Correspondent, Sunday Telegraph
Last Updated: 12:13am GMT 05/11/2006

The spread of a dangerous new superbug through hospitals is being hugely underestimated by the Government's reporting scheme, NHS staff have admitted.

The shambolic state of infection control on wards is exposed in a survey by the Patients' Association. It found only about a quarter of trusts are gathering data on Clostridium difficile (C. diff), the bacterium that experts say poses more of a risk to public health than MRSA (Methicillin-resistant Staphylococcus Aureus).

The findings from 500 infection-control nurses and managers follow mounting concern over the threat to patients' health from C. diff, which can cause severe illness and death in those with weakened immune systems, particularly the elderly.

The bacterium, which spreads easily through unhygienic and filthy wards, is the major cause of infectious diarrhoea, but it can also cause high temperatures and severe inflammation, and comes with a death rate of about five per cent.

Cases rose by more than 17 per cent last year, with 51,000 C. diff infections reported to the Health Protection Agency - but it appears the true number of those affected could be much higher.

advertisementThe University Hospitals of Leicester NHS Trust admitted last month that C. diff was likely to have killed 28 patients and was implicated in the deaths of a further 21 people since January.

At least 20 patients are feared to have died as a result of infection with the bacterium at Maidstone Hospital in Kent earlier this year and the Healthcare Commission is holding an inquiry. The Health Protection Agency has required all trusts, since 2004, to report hospital-acquired infections with C. diff in the over-65s, but the Patients' Association survey revealed that only 27 per cent of staff said this was happening in their hospital.

Nearly half of respondents said not all hospital staff were adequately trained in infection control and 47 per cent complained that much-needed cash for training was not ring-fenced.

Katharine Murphy, of the Patients' Association, said: "Collection of data about this very dangerous infection is haphazard to say the least, and we are not getting the true picture. How can patients have confidence in their hospitals if the real threat posed by C. diff is being played down?"

Dr Mark Enright, a microbiologist at Imperial College London, said that the government agency's monitoring scheme was flawed because a new and more dangerous strain of C. diff had emerged in the past year or so, striking patients aged 40 and over.

"The HPA monitoring system was set up hurriedly before this new aggressive type emerged, and what we are not getting from their reports is the number of people in the community with this form of C. diff, and the number of younger hospital patients affected," he said. "Some of the cases of diarrhoea are so severe that hospital treatment is needed. Once in a hospital it [the bacterium] can spread like wildfire and everyone on the ward will have some degree of infection.

"We need to know how many cases there are right across all age groups, not just the oldest ones, although they are more vulnerable."

A spokesman for the Health Protection Agency said the mandatory surveillance for C. diff was one of the most accurate national systems worldwide. "In 2005 all acute hospitals treating adult patients reported cases to the HPA. There is no evidence of widespread under-reporting and we are confident current figures are a broadly accurate estimate of the true number of people with C. diff in England and Wales."

A Department of Health spokesman said clean, safe care was not an "optional extra" for the NHS, adding: "Infection control should be a core activity for trusts."

Full results of the Patients' Association survey are due to be released tomorrow.

Also of concern is Acinetobacter baumannii:

Superbug brought back by Iraq war casualties By Colin Brown, Deputy Political Editor Published: 08 November 2006

Injured soldiers returning from Iraq have brought back a superbug that has been linked with outbreaks in NHS hospitals where they have been treated, a health minister has confirmed. The links between casualties brought back from Iraq and outbreaks in the NHS have caused alarm within the health service and led to renewed demands for more dedicated wards for Britain's armed forces to enable wounded soldiers to be isolated more effectively.

The Health Protection Agency has urged NHS hospitals to step up their infection control measures as a result of the outbreaks of a strain of the superbug Acinetobacter baumannii which is resistant to many types of antibiotics.

"A multi-resistant strain of A. baumannii known as the 'T strain' has been isolated from casualties returning to the UK from Iraq," the Health minister Andy Burnham said in a Commons written answer.

He said the exact source of the infection had not been identified but US casualties returning to America had also been found to be carrying the superbug.

Experts in microbiology who were studying the links between the infection and those wounded in Iraq, said an injured soldier thought to have caught the infection in Iraq may have caused a large outbreak of the superbug in an intensive care unit in an NHS hospital in south-east England.

They reported that the superbug was also found in two hospitals in the Midlands in soldiers who had been injured while serving in Iraq. The HPA said last night it was thought the T-strain survived in soil and sand in warm climates such as Iraq.

There was criticism last month of the treatment of injured soldiers on NHS wards after reports that a paratrooper wounded in Afghanistan was threatened by a Muslim visitor at Selly Oak Hospital in Birmingham, where many soldiers are treated. A campaign for a dedicated hospital for the armed forces was mounted with the support of forces' families. Tony Blair partially bowed to the pressure by announcing that troops would be given a dedicated ward at Selly Oak.

Reg Keys, whose son Tom was killed by a mob in Majar al-Kabir, Iraq, in June 2003, said the existence of the new strain of the infection underlined the need for dedicated facilities for the armed forces. "These lads are giving their lives for their country," he said. "The least they deserve is to be treated in military hospitals, not civilian hospitals, for reasons of security, but the existence of this superbug is very worrying. It proves the case even more for their own medical facilities."

Harry Cohen, the Labour MP for Leyton and Wanstead, who tabled questions about the superbug, said: "It is a worry that this bug which is infecting some of the wounded in Iraq is coming back to this country and could infect other patients in NHS hospitals. It does show that we need more separate wards for the armed forces."

At one hospital in Birmingham the bacteria is reported to have infected 93 people, 91 of them civilians. Thirty-five died, although the hospital was not able to establish whether the superbug was a contributory factor.

A. baumannii is resistant to most common antibiotics and, if left untreated, can lead to pneumonia, fever and septicaemia. It has been identified in more than 240 military personnel in the US since the 2003 invasion of Iraq, and has been associated with five deaths.

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