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Link: WHO TV - Des Moines
Very good article - click the link above for whole story
Nationally, about one out of every 20 patients gets an infection. At Marshalltown Medical Center, one patient in every 126. According to groups like the Committee to Reduce Infection Deaths(RID), people are getting infections they shouldn't be getting, and the non-profit group is leading the charge nationally to make infection rates public. Betsy McCaughey is the founder of RID. She favors mandatory reporting of infection rates, "If you need to be hospitalized, you should be able to find out which hospital has the worst infection problem so you can stay away." Right now, only six states have passed laws requiring the collection and reporting of those infection statistics. Those states are Florida, Illinois, Missouri, New York, Pennsylvania, and Virginia. Iowa is not on the list. Administrators at Marshalltown Medical Center feel so strongly about it's track record, they post it online. La Rae Schelling, the VP of Operations & chief nursing officer at MMC says, "Because people have a right to know where they're going for their healthcare." Representative Pat Murphy, whose wife is a nurse, agrees. "I do think it's something we need ... it's public education, and to make sure Iowa doesn't have a problem that could be resolved by doing these kinds of reports." Murphy introduced legislation last year that would've required hospitals to publicly post infection rates. The bill was referred to the Human Services Committee, and that's where it stopped. "I've only had one group state opposition to this...the hospitals.", says Rep. Murphy.
Link: Drug-resistant germ spreads across B.C..
During the past decade, several B.C. hospitals have had to close beds and units to contain outbreaks and to quarantine patients with such infections. In 2002, several babies in the special care unit at B.C. Children's Hospital tested positive for MRSA that was thought to have been brought in by either visiting relatives or a newborn who contracted it from the mother. The centre for disease control recommendations for doctors, including ensuring that blood tests are done and abscesses are drained and then cultured in a laboratory so the proper antibiotics are used, are expected to be posted for family doctors online in the B.C. Medical Journal today. As well, public health officials meeting in Victoria next week will be pressed by the centre for disease control to make MRSA a reportable disease so it can be monitored more closely. Because antibiotic resistance is thought to be growing as a result of antibiotic overuse, individuals should refrain from using antibacterial soaps in the home. And doctors are being urged not to give in to patients' requests for such medications in uncomplicated, localized skin infections which should instead be treated with hot compresses. Doctors who suspect more widespread infection in patients with such symptoms as skin infections, body aches and fever should be sure to refer them to specialists after draining lesions and doing swabs. Because of the fact that MRSA is not yet a reportable disease, province-wide numbers are unavailable, but Patrick expects B.C. will make it reportable "because we need the big picture and we can only get it by following surveillance patterns."
Link: Operation at....
A Woman who contracted the "superbug" MRSA while in hospital died of natural causes, an inquest heard yesterday. Teresa Box fell ill eight days after a knee replacement operation at Derbyshire Royal Infirmary on May 16, suffering diarrhoea and bleeding. She underwent several blood transfusions and, following an emergency operation, was found to have a duodenal ulcer and spent several weeks in intensive care. Her condition improved but she began bleeding again and tests revealed that she had MRSA and the Clostridium Difficile bug, a virulent strain of a common bacterial infection.
Link: baltimoresun.com.
In September 1999, Dr. Neil Novin decided to have his hip replaced so he could keep playing tennis. Within days of the surgery, his hip was badly infected with nasty, antibiotic-resistant bacteria known as MRSA. Although there is no way to be sure, Novin, a 76-year-old surgeon, is convinced that the source was likely something or someone he'd come in contact with at the hospital. Advertisement Since then, Novin, who lives in Pikesville, has had 11 more operations on his hip. He will almost certainly never play tennis again. Two million Americans a year contract an infection while in the hospital, and about 90,000 die, according to the latest data from the federal Centers for Disease Control and Prevention in Atlanta. Some critics say hospitals aren't doing enough to prevent infections and are urging more action. Some health and consumer groups are pushing for laws that compel hospitals to report infection rates and improve safety measures. Six states have passed reporting laws. Maryland could become the seventh within weeks; a bill making its way through the General Assembly would require all of the state's 50 hospitals to share with authorities - and the public - information about infections among patients.
Link: Examiner
AN MRSA victim advocacy group has questioned the methods being used by the Hospital Infection Society (HIS) to measure MRSA levels in the first extensive study of hospital infection in this country. The HIS is this week due to begin the study, in conjunction with the Health Protection Surveillance Centre (HPSC), aimed at establishing levels of MRSA and other hospital-acquired infections in 43 of the country’s acute hospitals. A hospital-acquired infection is a disease picked up by a patient within 24 hours of going into hospital, and includes MRSA, clostridium difficile and the vomiting bug, norovirus. Levels of infection will be measured using the ‘point prevalence’ system, which gives a snapshot of the number of people in an institution who have the disease over a particular period.
Link: CDR Weekly, Vol 16 no 08: News.
The demand for greater accountability with respect to hospital infections is bearing fruit as various infections become the subject of mandatory reports. See the link above for more
The National Glycopeptide-Resistant Enterococcal Bacteraemia Surveillance Working Group Report to the Department of Health has been published as a supplement to the Journal of Hospital Infection (1). This group was established to examine issues related to surveillance of GRE, in the light of surveillance of bacteraemias caused by glycopeptide-resistant enterococci (GRE) becoming mandatory. It reviewed methods used to identify and test the susceptibility of enterococci to glycopeptides, and made recommendations on the reporting of GRE bacteraemias. Among the recommendations made in the report are : * As the mandatory surveillance of glycopeptide-resistant enterococci (GRE) bacteraemias has already started, the report recommends a phased approach to some of the developments, such as using meaningful denominators for the bacteraemia rates. * Rates of GRE bacteraemias in trusts should not be used as a performance indicator because the numbers are too small for valid analysis in this way. * GRE bacteraemias as a proportion of all clinically significant bacteraemias in the trust should be measured as an indicator of changing trends. * Since most GRE are likely to be associated with specialist units, reports of GRE bacteraemia should indicate the specialty in which the patient acquired the infection.
Link: Infection Control Today
Healthcare-associated infections (HAIs) -- infections that patients contract in hospitals, nursing homes, or other care settings -- kill an estimated 90,000 patients each year in the United States. The National Quality Forum (NQF) announced a project to seek consensus on a set of national standards for public reporting of HAI data so that patients and their families can access this important information and providers can work to reduce such infections. An estimated 2 million Americans contract HAIs each year. HAIs include surgical site infections, ventilator-associated pneumonia, and urinary tract infections. Experts believe that up to 30 percent of such infections are preventable. HAIs add up to an extra $5.7 billion in healthcare costs. Despite their dramatic impact, no national standard for reporting HAI data exists. In the past two years, seven states have passed legislation requiring the reporting of HAI data, and more than 30 states have similar legislation pending. NQF will rectify this situation by endorsing national reporting standards and a standardized method for collecting, aggregating, and reporting HAI data that will allow comparisons across and among states and over time. Because of its transparent process and broad stakeholder participation, NQF-endorsed(TM) standards have special legal standing as voluntary consensus standards.
Link: BBC NEWS
The spread and development of the deadly hospital infection MRSA is to be studied by medical experts and researchers from Nottingham. State of the art computer technology will be used to assess data from hundreds of NHS wards. This is expected to establish a breeding pattern for the viruses and develop a best practice guide to stop them spreading. Researchers have said better analysis will give more practical results.
'Sophisticated methods'
The data analysed by the researchers includes the number of infected patients on a ward, the type of treatments and drugs they received and the methods used by hospital staff to avoid or control infections, including hygiene practices and quarantine rules. The study, will be led by Dr Phil O'Neill, of the University of Nottingham's School of Mathematical Sciences, and Dr Ben Cooper, from the Health Protection Agency in London.
Link: Guardian Unlimited
You've been reading of our doubts about this man for some time .... the Guardian are after him big time
I realise this is starting to look like a kind of dirty protest, but here is a window on to how the media sees itself in relation to scientific expertise, and how it copes with criticism, which just happens - entirely by coincidence - to involve the MRSA scandal. To recap: bloke with no microbiology qualifications in unaccredited garden shed "laboratory" finds MRSA on swabs given to him by undercover tabloid journalists for their "dirty hospital scandal" stories, but proper labs cannot find MRSA in the same places that this "leading MRSA expert Dr Chris Malyszewicz" (with his unaccredited American correspondence course PhD) has, and proper microbiologists have very good reasons for believing that the methods of this "expert" (who incidentally sells a range of anti-MRSA products) could not distinguish between harmless skin bacteria and MRSA. After the Evening Standard published an article starring Malyszewicz, "Killer bugs widespread in horrifying hospital study", in which it claimed to have found MRSA in some very unlikely places in UCL hospital, two senior consultant microbiologists from UCL, Dr Geoff Ridgway and Dr Peter Wilson, wrote to the paper pointing out the problems with its methods. Not only did the Evening Standard not bother to reply, it ran another story, two months later, using the same flawed methods.
Link: BMJ.
..... not sure what the comment below means in plain English......
Spiegelhalter shows what happens when hospital acquired infections are made targets.2 He also mentions but does not include difficulties with numerators and denominators in his calculations. With MRSA colonisation, the harder you look the more you find. Occupied bed days are frequently used denominators—at best a crude approximation to the true unmeasurable denominator of susceptible patients. Hospital systems first need to work in a stable, reproducible, and predictable way and then sequential analysis of surveillance data is required to ensure maintenance and further progress. There must be vigorous feedback for learning how to continue to do better. Within hospital data vary very much less than between hospital data, and many of the difficulties identified by Spiegelhalter vanish when we stick to using our own data sequentially. The mania for comparing hospitals has to be replaced with relentless implementation of systems based on best practice and sequential within institution monitoring. Duckworth and Charlett point out that knowledge about best practice is seriously deficient in some areas.3 Setting targets when little is known about mechanisms is doubly absurd. Clearly, extra effort is needed to try to fill the gaps. A potentially valuable tool is stochastic modelling as it seems to be capable of identifying the system factors that have the greatest influence. Central offices could do more to promote such research.
Link: Guardian Unlimited
MRSA Watch has questioned the activities of Chemsol Consultancy (not to be confused with the genuine Chemsol Ltd) for 6 months. Here is article that nails them
There are times when it's just great to be alive: you're running through the archives, the wind's in your hair, suddenly you stumble on a gem from last year's Sunday Mirror and it just makes you bless the day you decided to become a sarcastic and hateful campaigning science journalist. If this is going to make any sense we'll need a quick recap. For the last three weeks we have been following the sorry affair of MRSA in the tabloids. Every major tabloid newspaper in Britain - Sun, Mirror, Mail, Evening Standard and more - has sent undercover journalists in to take swabs from hospitals which were proven to be positive for the "deadly superbug MRSA" in laboratory testing by an expert. These results all came from Dr Chris Malyszewicz, and his Northamptonshire-based Chemsol Consulting. He is not a microbiologist; in fact, he is not a doctor, and has only a "correspondence course" PhD from a non-accredited distance learning institution in the US.
Link: BMJ.
This is the full article that refers to the difficulty of measuring MRSA reduction. Click the link above for more
One of the core standards set by the Department of Health is to achieve year on year reductions in rates of infection with methicillin resistant Staphylococcus aureus (MRSA).1 This was clarified in November 2004 by the (then) health secretary John Reid, who said that he expected "MRSA bloodstream infection rates to be halved in our hospitals by 2008," that "NHS Acute Trusts will be tasked with achieving a year on year reduction,"2 and that such a target was "achievable, measurable, and not too burdensome." Several problems can arise, however, when measuring change in rates, particularly when the observed number of events is fairly low. These include the effects of chance variability, regression to the mean, and low power to detect genuine underlying changes. These problems are accentuated with an infectious disease, since cases tend to cluster and hence rates are "over-dispersed" relative to chance variation.3 So how should we interpret government targets on MRSA infections?
Link: BBC NEWS
MRSA hospital league tables are meaningless because of the volatile nature of the superbug, an expert says. Medical Research Council statistics expert David Spielgelhalter said the infection occurred in clusters which could distort the true picture. The trend meant even if hospitals reduced the underlying risk it would not always be reflected in the regular infection rates published since 2002. But the government said the recording system was getting more sophisticated. Ministers introduced a mandatory surveillance scheme for MRSA four years ago, and last year set a target of a 50% reduction in rates by 2008. Other infection surveillance schemes for hospital bugs are also up-and-running.
Link: ABC News Online.
The Tasmanian Government is being asked to explain why it has stopped reporting on golden staph and other hospital-acquired infection rates in Tasmanian hospitals. The Liberals' Sue Napier says the Government has not included hospital-acquired infection rates in its most recent Health Department annual reports. A superbug called MRSA, also known as golden staph, has been found in 120 people who died in Victorian public hospitals between June 2004 and May 2005. Ms Napier wants to know why the information was deemed to be of public interest in 2002, but not in subsequent reports. "Well, ever since there was an announcement that there had been a blow-out in the number of MRSA or golden staph cases in Tasmanian hospitals for 2001 and 2002, the Tasmanian Government has failed to include it in their annual reports so the public just doesn't know whether we currently have the kind of problem that is arising in Victorian hospitals or not," she said.
But the Department of Human Services' Dr Jenny Bartlett says the mere presence of MRSA does not mean it was the cause of death. "We have no way of differentiating whether they died of or with the bug," she said. Dr Bartlett says many of the patients died of cancer, pneumonia, organ failure or severe burns. Professor Peter Collignon from the Canberra Hospital says better reporting is needed, but it is not uncommon for hundreds people die from the infection in Australia each year. "A lot of these people have got severe underlying diseases and acquiring the infection, doesn't really make a lot of difference to what would happen to them," Professor Collingnon said. "However, there are reasonable number of people who get quite severe infections - not only MRSA, but ordinary golden staph while in health care - and quite a number of those people can die."
Link: Guardian Unlimited
The NHS watchdog is failing to provide patients with an accurate picture of hospital hygiene and superbug rates, consumer groups and doctors' leaders said today. The Consumers Association, the Patients Association and the British Medical Association (BMA) branded the Healthcare Commission's latest assessment of hospital cleanliness and MRSA infections as worthless and unambitious. They also warned that new performance rating system does not go far enough to address the flaws in the star ratings, which it replaces from next year.
Much more at the link above
Link: The New Zealand Herald.
Monitoring of a hospital "superbug" will be reduced next week, partly to save money. The Institute of Environmental Science and Research will stop producing its weekly report on case numbers of strains of methicillin-resistant staphylococcus aureus (MRSA) that are resistant to multiple classes of antibiotics. The Ministry of Health pays ESR to produce the information. Implementing an advisory committee's recommendation, the ministry no longer wants the weekly reports. But ESR will continue with its annual survey of all MRSA samples sent to it in a one-month period by hospital and community laboratories. This includes the multi-resistant strains.
Link: Times Online.
PATIENTS are being exposed to an unknown number of potentially lethal hospital superbugs because of the Government’s failure to address a “fog of ignorance” in the NHS, a powerful group of MPs said yesterday. The Public Accounts Committee (PAC) has condemned the lack of adequate monitoring of hospital-acquired infections and the Government’s reliance on “rough and ready” figures that are up to 20 years out of date. Infections picked up in healthcare environments are said to amount to at least 300,000 a year in England, with an estimated 5,000 deaths and costing the NHS as much as �1 billion. Only figures for MRSA — methicillin-resistant Staphylococcus aureus — are now published after mandatory surveillance. The committee said that this accounted for less than 6 per cent of all hospital- acquired infections (HAIs). The PAC said that four years had passed since it first highlighted the shortage of information about the bugs, yet a full surveillance programme had still not been put in place. Monitoring of four other infections has been introduced over the past two years, including the potentially fatal Clostridium difficile, but no findings have yet been published.
Link: ottawasun.com
When it comes to hospital superbugs, the Ontario Council of Hospital Unions wants the province to take tougher action. With a mobile hospital room in tow, the council was in Ottawa yesterday to outline steps it believes should be taken. President Michael Hurley said legislation requiring hospitals to report outbreaks of superbugs like C. difficile and MRSA is necessary. Patients should know a hospital's status before they go there for treatment, he said. 'NONCHALANT' ATTITUDE "It's something we should expect in Ontario," he said, adding the government's attitude is "nonchalant." Not so, said Dan Strasbourg, spokesman for the Ministry of Health. The province has a list of about 75 reportable diseases under the Health Protection and Promotion Act. While C. difficile is currently not on it, the provincial infectious diseases advisory committee is looking at possibly including it.
Link: Guardian Unlimited Politics
The whole article is worth reading.
More than one in eight hospitals have under-reported the number of MRSA infections for as long as three and a half years, new documents reveal. Fears about the true scale of the superbug problems in Britain's hospitals grew today as the Department of Health admitted for the first time that 13 per cent of trusts had broken their own rules on reporting cases. They had excluded from official reports cases of MRSA infection in patients believed to have had the bug before coming into hospital. Article continues Since April 2001, all trusts have been required to report all MRSA bloodstream infections, regardless of where patients acquired it. But an unpublished survey carried out by the DoH last year revealed that some trusts had failed to comply with this, resulting in an inaccurate picture of the scale of the problem in trusts.
Link: Post.
The revelation comes two weeks after it emerged that the number of Irish MRSA cases had been under-reported for years because laboratories were allowed to opt out of the MRSA reporting scheme. But Pat McLoughlin, the director of the National Hospitals Office (NHO), said that the HSE planned to start compiling figures for each hospital soon. “Work is being carried out to determine what information should be compiled and published,” he said. He said the results of the forthcoming national hygiene audit would be published but that the process was not about shaming poorly performing hospitals.
Link: icNorthWales
AN expert yesterday aimed to shatter "the myths" surrounding hospital superbug MRSA. Dr Tony Howard, Wales' leading specialist on the killer infection, said public fears over the bug were overstated. Speaking to community health council workers from across the country, the former Ysbyty Gwynedd doctor said there were five great myths over hospital infections that needed shattering. Dr Howard said: "We hear that all infections are preventable. They are not. That MRSA is the sole problem - it is not. That it's a killer bug - it is not. On the spectrum of killer bugs, it is a fairly medium player. " We hear health care-associated infections have escalated beyond control - they haven't. We hear the UK is worse than everywhere else - it isn't, it's similar to most countries in Europe.
Link: Rate of hospital infections difficult to obtain.
The rate of infections acquired by patients while in the hospital may be one of the best-kept secrets in health care. Although hospitals must report various types of illnesses, including communicable diseases and hospital-acquired infections, to the Department of Health, they aren’t required to publicly report numbers. And indeed, many hospitals don’t. "That’s privileged information," said Ruth Sickler, infection control coordinator for A.O. Fox Memorial Hospital in Advertisement Oneonta. "I’m not free to share those numbers," said Ruth Blackman, infection control coordinator at Bassett Healthcare in Cooperstown. Hospitals won’t release the information, said Fox spokeswoman Maggie Barnes, because there isn’t a fair comparison between hospitals. "You can’t compare hospital A to hospital B with infection rates," Barnes said Tuesday. "You just can’t do that." The New York Public Interest Research Group is lobbying for several pieces of legislation that would require hospitals to pu What's Related # Hospital smell attributed to cleaning products # Doctor runs no-insurance clinic # Area health briefs blicly disclose information regarding hospital-acquired infections and the rates.
Link: HDA: News.
The health minister has admitted that better statistics distinguishing between hospital-acquired and imported Methicillin-Resistant Staphylococcus Aureus are needed. Lord Warner told a panel session at the Patient Association's Cleaner Hospitals Summit that there was a need for more reliable information indicating the origin of infections detected within hospitals and voiced his support for efforts already being undertaken by hospital chief executives and the government. The panel included health spokespeople from each of the UK's leading political parties and selected healthcare figures, who outlined what they believed was the way forward in dealing with major healthcare issues, such as MRSA. Paul Burstow, health spokesperson for the Liberal Democrats, said a new government target for reducing MRSA rates by half by 2008 "misses the point" and could distort priorities within healthcare. He claimed that the focus should be on community and what efforts were being made to implement the Department of Health's hospital circular issued in 2000, suggesting that social care workers should be "working together" with hospital staff to address the problem of hospital infections.
Link: Sunderland Today
Interesting case of MRSA semantics here by the hospital. The patient may not have died from MRSA but did multiple bouts of it hasten his death or fatally weaken him?
AN ANGRY son claims his elderly dad died after being struck with MRSA at Sunderland Royal Hospital. Ralph Brough says his father, also called Ralph, suffered a series of infections during his nine-week stay at the hospital and lost 11 kilograms in weight. The family claim the infections weakened the 91-year-old great-grandfather, from Seaham, and he died six days after being discharged from Sunderland Royal. But hospital bosses say there is no evidence that Mr Brough died from MRSA and have assured his family they did everything they could to help him. They said his family wrote to thank hospital staff after his discharge. But Mr Brough, 64, said: "I feel that if my father had not had to enter hospital he would still be with us now, as the series of infections which he picked up in the ward created a downward spiral. "He died in his sleep, an extremely frail and feeble man and a shadow of the man who had entered the hospital." Mr Brough's father was admitted to Sunderland Royal Hospital after a fall in December at his Northlea home, where he lived with wife Marion, 89. He says his dad caught infections in chest, eye, nose, mouth, rectum and bowel during his stay and suffered thrombosis in his leg. Mr Brough said: "We were advised by staff at the hospital that the MRSA bug had caused most of his problems, although the differing treatments and drugs for all his infections and conditions seemed not to improve his health."
Link: Nosocomial Infection Surveillance System (KISS)..
Data from 274 ICUs and 505,487 ICU patients were recorded and a total of 6,888 cases of nosocomial pneumonia and 2,357 cases of primary BSI identified, of which 1,851 cases of S. aureus pneumonia and 378 cases of S. aureus primary BSI were considered for analysis. 59 of the 349 patients with MRSA pneumonia (16.9%) and 105 of the 1,502 patients with MSSA pneumonia (7.0%) died. 16 of the 95 patients with primary MRSA BSI (16.8%) and 17 of the 283 patients with primary MSSA BSI died (6.0%). Four factors were significantly associated with mortality from S. aureus pneumonia, one of them being pneumonia caused by MRSA (OR = 2.62; CI95 1.69-4.02). Only MRSA was significantly associated with death from S. aureus primary BSI (OR = 3.84; CI95 1.51-10.2). CONCLUSION: : Nosocomial pneumonia and primary BSI from MRSA may be associated with death, but the cause-effect relationship of severity of illness and MRSA remains to be determined due to the limitations of surveillance data.
Link: Bexley Express.
And Dr Kensit is sure to anger the family after playing down the link between MRSA and the cause of death. He added: "If it has contributed then it may well go on [the death certificate]. "But I know that quite frequently, although a patient may well have picked up MRSA at some time during their stay, it actually is of no clinical relevance at all when it comes to cause of death. "I have the impression that there is a feeling that if you have MRSA at any time at the hospital, then it has to be on the death certificate, but that seems to me to be nonsense." Mr Kensit moved to quash the rumours of a link between ward cleanliness and the MRSA bug. He said: "It is actually quite difficult to find hard evidence to show how these organisms are transferred. We regard the social cleanliness of the ward to be not terribly important when it comes to MRSA infection. In other words, you could clean it so it is shiny but it is unlikely you would notice any difference in your MRSA rates. "The major issue really is transferring it from patient to patient and staff to patient. We're concentrating on this and we're trying to interrupt the transfer of organisms."
Link: Mrsa: 5 Apr 2005: Written answers (TheyWorkForYou.com).
Tim Loughton (East Worthing & Shoreham, Con) Hansard source
To ask the Secretary of State for Health (1) how many cases of MRSA have been reported involving kidney patients receiving treatment through intravenous tubes in each of the last three years; (2) what measures have been taken to prevent MRSA infections being contracted during dialysis treatment.Melanie Johnson (Welwyn Hatfield, Lab) Hansard source holding answer 23 March 2005 Figures on the incidence of methicillin resistant Staphylococcus aureus (MRSA) in kidney patients dialysed using central venous catheters are not available. All national health service trusts need to take steps to control MRSA and other healthcare associated infections and general guidance on infection control is set out in "Winning Ways: Working together to reduce healthcare associated infection in England". Specific advice on infection control in dialysis units has been issued by the Renal Association in "Treatment of adults and children with renal failure—standards and audit measures".
Link: BBC NEWS
Dr Jodi Lindsay, lecturer in infectious diseases at St George's hospital, said: "Lots of people carry Staphylococcus aureus up their nose. "About 20-30% carry it up their nose all of the time and another 50% carry it occasionally. "It lives up your nose and is meant to be there. It has evolved with us and is part of our normal bacterial flora. "It does not cause disease normally. It is what we call opportunistic - it has to be put in the right situation to cause disease. It needs to be transported to an open wound for example." When these bacteria do cause disease, most healthy people can shake off the infection naturally and may not even realise that they have had it.
Link: Mrsa: 22 Mar 2005: Written answers (TheyWorkForYou.com).
Andrew Lansley (South Cambridgeshire, Con) Hansard source
To ask the Secretary of State for Health for what reasons his Department decided that data collected for MRSA rates under the mandatory surveillance system should be published every six months; on what date this decision was made; what representations he received from (a) NHS organisations and (b) other interested bodies in support of publishing data under the mandatory surveillance system at six monthly intervals; if he will publish all data collected under the mandatory surveillance system since April 2001 for intervals of six months; and what plans he has to publish data under the mandatory surveillance system at intervals of three months.Melanie Johnson (Welwyn Hatfield, Lab) Hansard source
holding answer 14 March 2005
The Department decided to publish data from the mandatory methicillin resistant Staphylococcus aureus (MRSA) surveillance system on a six-monthly basis so that the public could be informed more frequently about the record of their local national health service trusts. The decision was taken in February this year, after consulting the Health Protection Agency, to ensure this would not over-burden specialist NHS resources and that data published at this frequency would be meaningful The tables published on 7 March 2005 include all the data collected through the mandatory MRSA bloodstream infection surveillance system since 2001, set out in six-monthly intervals. The Department has received no other representations on this issue and there are no current plans to publish this data on a quarterly basis. The tables are available on the Department's website at www.dh.gov.uk/assetRoot/04/10/55/18/04105518.pdf and have been placed in the Library.
Link: Mrsa: 5 Apr 2005: Written answers (TheyWorkForYou.com).
Nigel Dodds (Belfast North, DU) Hansard source
To ask the Secretary of State for Northern Ireland how many deaths in Northern Ireland in each of the last five years have been attributed to MRSA; and what guidelines are used in recording the numbers of deaths in which MRSA has been a factor.Ian Pearson (Dudley South, Lab) Hansard source
The numbers of deaths where Methicillin Resistant Staphylococcus aureus (MRSA) was mentioned on the death certificate in Northern Ireland, for the registration years 1999–2003, are given in the table as follows. Number of deaths in Northern Ireland with MRSA mentioned on the death certificate by registration year 1999–2003Registration year Death certificate mentioned MRSA
1999 13
2000 14
2001 16
2002 25
2003 30Total (1999–2003) 98
The International Classification of Diseases (ICD) is used to classify cause of death and the current version of ICD does not have a specific code for MRSA. The statistics reported in the table have been obtained by identifying all deaths with ICD codes likely to be linked with MRSA, and checking the relevant death certificates for mention of MRSA.
Link: BBC NEWS
Ms Russell, from Winson Green, Birmingham, believes she was infected at City Hospital in Birmingham while giving birth by Caesarean section. "They sent me home, and the only way I found out was from my midwife writing into my post-natal case notes," she said. "They never told me. They covered it up. And when we asked them, they still denied it. And now I am here with an open wound which could take up to 12 months to heal." Mr Blair responded: "I'm very sorry about your individual case and I hope the trust is looking into it. "It is important, though, that we recognise that it is still very rare that people contract this.
Link: Conservative Party - Press release.
Mr Blair was questioned today on Sky about the Government's failure to provide a mandatory surveillance system for MRSA. Commenting, Shadow Health Secretary Andrew Lansley said: "Labour's MRSA statistics don't accurately reflect what is going on. Conservatives have repeatedly called for surgical site infections to be recorded. Even Mr Blair's chief medical officer made the same suggestion a year ago. But the Government has failed to do this, except for orthopaedics. "We need to provide genuine information on infection rates in order to clean up our hospitals. Conservatives will do this. We will implement our action plan to deliver cleaner hospitals".
Link: Scotsman.com
Prime Minister Tony Blair was today confronted by a woman stricken by the MRSA superbug who claims the hospital covered up her infection. Mother-of-four Rebecca Russell said she only found out she had caught MRSA during a Caesarean operation after reading her midwife’s notes. The 28-year-old told Mr Blair she was now “here with an open wound which could take up to 12 months to heal”. Miss Russell’s furious mother, Sandra McKellar, joined her daughter in making the allegations of a cover-up, claiming it was so no-one knew how many people were dying from MRSA. The confrontation came as Mr Blair endured two hour-long interrogations on health and crime on Sky News.
Link: dailyrecord
HOSPITALS are trying to hide the number of patients dying from the MRSA superbug by not recording it on death certificates, it was claimed yesterday. Campaigners calling for urgent action to tackle the bug suspect that the true number of MRSA deaths is far higher than the number admitted by the Government. Tony Field, chairman of MRSA Support, said: 'This story is not unique. We believe that around half our members who have lost loved ones to MRSA did not have the fact recorded on the death certificate. 'It appears hospitals are not keen on putting MRSA on certificates because it has to go on their figures.' Government rules were tightened last April to make it mandatory to record MRSA on death certificates if it was a factor.
Link: Portsmouth Today
More fuel for the under reporting row surfacing after the death of Baby Luke
MRSA was a major factor in the death of a hospital patient despite doctors failing to put the 'superbug' on his death certificate. The body of David Cheatle had been stuck in the mortuary at St Mary's Hospital after his grieving son flatly refused to accept doctors telling him Mr Cheatle had died from lung cancer and pneumonia. A post-mortem examination ordered by hospital staff yesterday confirmed what the family suspected – MRSA had significantly contributed to his death. Now, two weeks after Mr Cheatle's death, his relatives can finally bury him. Mr Cheatle, of Crown Street, Landport, said: 'We are very angry – the death certificate is a legal document and it did not reflect the whole truth. 'In a funny way this could be doing the hospital a favour because they need to know the true picture if things are going to get better.' Pat Forsyth, spokeswomen for Portsmouth Hospitals NHS Trust, said the original failure to put MRSA on Mr Cheatle's death certificate was not deliberate. She said: 'The doctor makes a clinical judgement as to the major cause of death at the time of a patient dying. The trust certainly does not try to influence the process.'
Link: HighWire Press -- Medline Abstract.
S. aureus bacteremia (SAB) was defined as hospital acquired if the first positive blood culture was performed more than 48 hours after admission. Other SABs were classified as healthcare associated or community acquired according to the definition proposed by Friedman et al. When available, strains of methicillin-resistant Staphylococcus aureus (MRSA) were analyzed by pulsed-field gel electrophoresis (PFGE). RESULTS: Eighty-two patients were considered as having community-acquired bacteremia according to the Centers for Disease Control and Prevention (CDC) classification. Of these 82 patients, 56% (46) had healthcare-associated SAB. MRSA prevalence was similar in patients with hospital-acquired and healthcare-associated SAB (41% vs 33%; P > .05), but significantly lower in the group with community-acquired SAB (11%; P < .03). PFGE of MRSA strains showed that most community-acquired and healthcare-associated MRSA strains were similar to hospital-acquired MRSA strains. On multivariate analysis, Friedman's classification was more effective than the CDC classification for predicting MRSA. CONCLUSION: These results support the call for a new classification for community-acquired bacteremia that would account for healthcare received outside the hospital by patients with SAB.
Link: this is southwales
Health Minister Brian Gibbons has admitted that official MRSA figures released for hospitals across Wales only tell part of the story. The statistics, from the Welsh public health service, only relate to cases of MRSA blood poisoning. Infected wounds which may not deteriorate into full-blown blood infections are not included in the tables. Neither are MRSA-positive swabs from patients.
Link: Mid Sussex Today
LEWES MP Norman Baker says there are fundamental flaws in the system for reporting MRSA cases, which have led to a significant underestimate of numbers. In a letter to Mr Baker, the government's Registrar General admits that current guidelines given to doctors only recommend rather than legally oblige them to report MRSA as a contributory factor in patient deaths. Mr Baker believes this has led to many cases going unreported. "This is a crisis in which the government is guilty of misrepresenting the true extent of patient deaths involving MRSA," he said. "The welfare of patients is paramount and the government must now come clean over the scandal of these unreported deaths and amend forthwith the guidelines issued to doctors."
Link: BMJ.
Figures released this week from the government's mandatory reporting scheme on Staphylococcus aureus bacteraemia infections acquired in hospital show an increase of almost 8% between 2001-2 and 2003-4, from 17 933 to 19 311. Forty per cent of the 19 311 infections in 2003-4 were methicillin resistant Staphylococcus aureus (MRSA), making the United Kingdom's rate one of the worst in Europe. The number of MRSA infections alone rose by almost 5% between 2003 and 2004. These findings, which come from the Health Protection Agency, follow a report from the spending watchdog, the National Audit Office, which criticises the government's tardiness in implementing a national mandatory surveillance programme. Four years after publication of its first report on hospital infections the watchdog found that implementation of its original recommendations had been "patchy," despite policy guidance from the Department of Health.
Link: Western Daily Press.
Dr Reid said estimates of patients killed by MRSA were often wildly exaggerated. Some people claimed the superbug killed 5,000 a year, but the Health Secretary insisted the true figure was 321, out of more than seven million patients. And just one baby a year had been killed over the past four years. "I have tried to treat this very seriously, but it is not helped by wild exaggeration, and I would not want anyone to think the net gain of going to hospital is outweighed by the risk of MRSA," he said.
Link: Guardian Unlimited | The Guardian | The threat from MRSA.
You suggest (Leaders, February 28) that the nearly 1,000 deaths from MRSA in 2003 reported by the Office of National Statistics introduces "a calmer voice" into the debate - because that figure is "only a fifth" of the 5,000 the National Audit Offic estimates. This is a false piece of reassurance. The (rough but best available) estimate of 5,000 deaths in our report related to deaths from all hospital-acquired infection. The ONS reports deaths where the death certificate mentions MRSA - which have increased 15-fold since 1992. This is bound to be a significant underestimate of total deaths from MRSA because doctors need not record MRSA as the cause of death. The real message is that MRSA, albeit very serious, is just one kind of hospital-acquired infection. There are many others, some even more deadly. What we need is solid data about all of them. Karen Taylor National Audit Office
Link: Groups Reach Consensus on Healthcare-Associated Infections.
Consensus for the development of a national standard for infection rate reporting was reached on Tuesday among experts in infection control and prevention, representatives from state government agencies, public health, and consumer groups. The action followed a two-day consensus conference in Atlanta this week, during which the Association for Professionals in Infection Control and Epidemiology (APIC), reiterated its commitment to creating a safer environment for patients. Kathy Warye, APIC’s executive director said, “We accomplished the goal of the conference by reaching consensus that development of a national standard for public reporting is the best approach for providing consumers with meaningful and reliable information.” “As patient safety advocates, we are devoted to infection control and prevention, and recognize the importance of providing consumers with comparable infection rate information,” said APIC president Sue Sebazco, RN, CIC. Lisa McGiffert, representing the Consumers Union (CU), spoke to attendees about CU’s Stop Hospital Infections campaign, and stressed the important role of the infection prevention community. “We think infection control is fundamental to healthcare and to making this [reducing infections] work. We hope that what comes out of all of this is that infection control professionals get more support for what they do. Patients will be safer as a result. We believe you need more visible roles and I look forward to working with you to pursue these efforts.” Joining APIC in presenting this conference were the Centers for Disease Control and Prevention, the American Hospital Association, Consumers Union, National Quality Forum, and the Society for Healthcare Epidemiology of America.
A short introduction from Dave Roberts
This 12 minute introduction will help you grasp the key facts and the key issues surrounding drug resistant staph aureus (mersa, mursa)
