It has come to the attention of MRSA Action UK that the Government and the Department of Health is considering a proposal to move away from universal screening for MRSA, MSSA and E-coli. In a bid to save money it is proposed to move towards a method of selective screening following a national one week study of the universal MRSA screening policy.
As the leading charity dealing with patients who approach us on a regular basis with questions and concerns about MRSA and going into hospital, we were disappointed not to be included in the design of this study. We now ask if selective screening is conducive with zero tolerance towards avoidable healthcare associated infections, or if “zero tolerance” just the usual rhetoric we hear from politicians.
As we look back at the great strides that have been made in reducing the burden of healthcare associated infections in our hospitals, we can see that the latest figures show that MRSA bloodstream infections remain at the same level as they did last year for people being treated in hospital. There has been a reduction in the number of MRSA bloodstream infections in the community, although not as significant as those in the acute hospital setting, where we have seen a 95% reduction since MRSA was at its peak in 2004, with 7,684 patients affected. So there is certainly no room for complacency or a time to relax and think the job is complete which such a lot to do in the community.
Using Public Health England’s statistics and looking at the 13-month period from August 2012 to August 2013, there were 442 cases in hospital, just one less than the same period last year. Community attributed MRSA bloodstream infections numbered 991, a 9% reduction on the same period last year.
MSSA bloodstream infections, which are more responsive to the group of Meticillin antibiotics, yet just as debilitating, have seen a 3% increase in the community however, with 9,794 being picked up in the 13 month period.
We would remind the Department of Health that the bloodstream infections are just a marker in terms of prevalence of healthcare associated infections, and that significant numbers of surgical site infections still go unreported despite our campaigning for these to be monitored and published in the way bloodstream infections are.
At the annual Infection Prevention Society Conference last week, a London hospital reported that just by being more persistent with post discharge surveillance and extending their patient contact from 5 days post discharge to 10 days, they picked up far more infections. The patients that were involved had undergone Caesarean section operations. Wound care was thought to be a major contributor in these instances.
Another study showed there are cases of Mupirocin resistance in the South East. In addition, trials at another London hospital showed that if universal screening of patients is halted and targeted at just specific groups of patients, then it is likely that around half of people being admitted to hospital who are carrying the superbug MRSA on their skin may be missed by selective screening. This is despite assertions from the Department of Health that only 20% may be missed if selective screening was introduced.
Our battle with MRSA and other superbugs continues. Screening and understanding the transmission of MRSA and MSSA has to remain a priority. A recent study of patients who had been screened for MRSA showed that 95% thought that screening was the right thing to do, and believed it helped to reduce infections; this gives confidence to patients when going into hospital.
Screening and effective treatment for MRSA or MSSA positive patients needs to be carried out at the right time, as in some cases it is only possible to suppress MRSA. It is therefore vitally important that we do not take our eye off the ball and allow MRSA to dominate hospital wards in the way it did at the beginning of this millennium, reaching its peak in 2004.
We must not return to the past and we urge the Department of Health not to reduce the interventions, but to put the necessary resources into healthcare. You cannot on the one hand say you have zero tolerance to MRSA and avoidable infections, and on the other cut the resources to deliver that pledge.
We would remind the Government and the Department of Health that they have a duty to give us the healthcare we deserve and we must keep up the good work that has gone into reducing the numbers of people affected by MRSA and other healthcare associated infections.
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