Ireland has highest rate of superbug in Europe

Villain

From BreakingNews.ie

Ireland has highest rate of superbug in Europe
06/06/2005 - 12:09:05

Ireland has a higher rate of the deadly hospital superbug MRSA than any other country in Europe.

A report published by the Irish Patients Association says the bug is one of the biggest health problems facing the country.

They are calling on Health Minister Mary Harney to introduce new laws to monitor the rate of the disease.

A little background info:

MRSA is a bacterium. The initials stand for Methicillin Resistant Staphyllococcus Aureus. Under normal conditions the staphilococcus bacteria are relatively harmless. We live with many different kinds of bacteria (staphyllococcus aureus included) in us and on us without any harmful effects. Problems occur when it gets into the bloodstream through a cut or broken skin, particularly if the immune system is weakened, because MRSA can in certain instances be fatal.

Im simple terms a lot of people have this bacteria present in their noses or under the armpits atc and it's harmless unless the bacteria comes in contact with an open wound, and it is most likely to infect you if you immune system is weak. So basically if your sick and this bacteria comes in contact with your wound there is a very high chance you will be infected.

It is widely accepted that the main source of infection is from doctors and nurses not washing their hands, I don't have stats at hand but I remember a survey finding that only 4 in 10 doctors regulary washed their hands between patients. So basically most people are infected by the hands of doctors or nurses. A person of any age can be infected although it is a lot more common among people over 75 as there immune systems would be a lot weaker.

The reason MRSA is so dangerous is that is immune to most antibiotics except two; Vancomycin and Teicoplanin, but these aren't always able to cure the infection either and these are very toxic which can cause serious side affects, they are also very very expensive and must be administered intravenously so you must remain in hospital while receiving the treatment.

The problem in Ireland is that there has been a cloud of secrecy around MRSA for years a lot of people who die from the disease don't have it listed on their death cert. Stats are very hard to come by in the Rep. Of Ireland, the only ones I know of are that 12 people died of the disease in 1998 and in 2003, 477 cases were reported in the Rep. of Ireland. The NDSC has advised that the total number of cases notified for the first two quarters of 2004 was 274.

The UK have far more stats available and I have found some stats from Northern Ireland which show that



The Minister for Health stated in the Dail on the 2nd of December 2004 that in the region of €4.5 million had been allocated to tackle MRSA and other antimicrobial resistant organisms in 2004. On prime time last week a spokesman stated that most of this money was spend on new Microbiologists.

My father contracted MRSA in Beaumount hospital in 1998 and it was only after a relative had read his chart and asked what MRSA was that we were made aware of the infection. My fatehr spent over a year and a half in hospital due to MRSA and as a result he is now disabled for the rest of his life. During his time in Beaumount he was in a standard ward and the doctors and nurses who treated him didn't always wear gloves and never wore protective aprons. He was transferred to Cappagh and he was put in an isolation ward and ANYONE who entered the ward had to wear gloves and an apron. These are two hospitals in the one city and they treated the infection in two totally different ways.

The Health department must allocate money to an awareness programmes so that nurses and doctors are made more aware of the risks they put patients at by not washing their hands, also pateints should be informed of what MRSA is and how infection can be avoided. The secrecy around MRSA has to stop and the government has to act on this issue.

Sorry for the leghty post

athena 2000

What a shame your father has suffered due to lack of proper cleanliness procedures. My Dad was also subjected to a staph infection after surgery a few years ago.

It isn't just the lack of washing hands before touching patients that's the trouble, but also the equipment that so many staff members share on a daily basis - the PC keyboards and telephones, fax machines, and other biomedical equipment.
Article: Dirty PCs fuel hospital superbugs

Even those that wash their hands can pick up the MRSA bug again just by touching the tap to turn off the water. MRSA strains in hospitals can be stronger than in communities outside the hospitals.
Article: Hospital superbugs

At least the Cappagh hospital seems to have had good procedures in place. Money spent on a public awareness campaign along with nationally standardized and improved disinfection procedures within the hospitals would be a step in the right direction.

Too bad you can't put a whole hospital complex into an autoclave!

bonkey

athena 2000 wrote:

Too bad you can't put a whole hospital complex into an autoclave!

Well, they manage to do something in other countries to keep the incidence rate lower....

jc

Villain

Thanks for the links athena 2000, if I remember correctly the bacteria can only survive on most surfaces for an hour. Haven't seen first hand waht this infection can do I would be very careful now when receiving any medical attention. I know when your ill in hospital you just want to treated as quickly as possible but I certainly would never let a nurse or doctor near a wound unless they were either wearing new sterilised gloves or had just washed their hands before touching me.

I know that might sound a little ott to some people, but unless people force staff to take the required precautions MRSA will continue to spread and believe me this is one infection you don't want. MRSA is a killer, and if it doesn't kill you it would certainly leave you with problems. This bug can eat through bone in no time and it is very hard to treat and all that is needed to prevent infection is cleanliness.

Really people our government spending €4.5 million of a few more staff every year won't stop this bug, Ireland has nearly twice as many infections per million than any other country in Europe!

I saw a report on BBC's newsnight last night on a new hospital superbug which has caught up with MRSA with the number of deaths there relating to it in theUK
Link

Incidently my own Father died from MRSA in st Vincents private hospital which kind of indicates that theres more than just the public health service and ergo the department of health/ministers/government to blame for its prevalence.
You would imagine the hygene there would be up to scratch and we saw no reason to suggest otherwise.

Curiously we also werent told about MRSA untill we inquired,though we were wearing all the protective gear when visiting him and witnessing the barrier nursing(the special precautions the health care staff must take to prevent it spreading) when we were there.

bonkey

Knew this all rang a bell....

mycroft had this to say about it before.

Villain

Yep and since then we have overtaken the UK, I really can't understand why this issue hasn't received more attention. The solution is so simple, I mean this can and does kill people and all that is needed to prevent the spread is for hospitals to be properly cleaned and staff to wash their hands before attending to patients

You know what else bugs me is that when I post on this forum in support of SF I get a tonne of people responding to me, but when I bring an issue like this up it gets next to no responses. :mad:

HelterSkelter

I had an operation in St James's Hospital in 2003. While I was in I was moved to a ward with a single bed (no apron/gloves on entering). I was told the reason for this was that when I was in for a previous operation in 2002 I tested positive for MSRA. I wasn't given much more information about it and didn't realise it could be very serious. I was happy in a room on my own away from the crazy other people I had been sharing a ward with!

One of the things I noticed in James was the toilets in the wards were filthy. While the wards were cleaned regularly they seem to have something against cleaning the toilets. The same urine stains were on the floor for days on end. A few times I had to ask them to clean the toilets as they were so bad.

With regard to wasing hands I reckon about 50% of the time the doctors/nurses would wash their hands before/after touching you.

county

what helterskelter has posted just horrifies me,it just shows what a mess the health service is in,hope i never get sick

Villain

Its the harsh reality that is our health service county and without proper management it won't change and that won't be happening for a while now that a second person has failed to take the HSE job.

Mary Harney has done sweet FA since she has taken over.

HelterSkelter

HelterSkelter wrote:

One of the things I noticed in James was the toilets in the wards were filthy. While the wards were cleaned regularly they seem to have something against cleaning the toilets. The same urine stains were on the floor for days on end. A few times I had to ask them to clean the toilets as they were so bad.

Thats the nubb of it really.
Motivation.No amount of money thrown at a health service will encourage people to wash their hands all the time or check that the toilets are ultra clean which is the way they are supposed to be.
Theres a report chart on the inside of the toilet doors(or there should be) indicating when they were last cleaned and who by.
In my opinion, toilets in that state should be a sacking offence, pure and simple.

irish1 wrote:

You know what else bugs me is that when I post on this forum in support of SF I get a tonne of people responding to me, but when I bring an issue like this up it gets next to no responses. :mad:

With respect this thread is not about SF.

irish1 wrote:

Its the harsh reality that is our health service county and without proper management it won't change and that won't be happening for a while now that a second person has failed to take the HSE job.

my dad got it in a private hospital,I understand its rife in them.The famed Blackrock clinic doesnt escape and indeed last year had to impose a no visitors order.

Mary Harney has done sweet FA since she has taken over.

Given that we know what the causes and spread of the disease is, what do you expect Harney to do exactly short of trying to get people to have a more diligent approach to cleanliness?
You are dealing with human nature there, not resources.

Villain

Earthman wrote:

With respect this thread is not about SF.

That was my point earthman if it was and I posted I'd have had a flood of replies.

Earthman wrote:

my dad got it in a private hospital,I understand its rife in them.The famed Blackrock clinic doesnt escape and indeed last year had to impose a no visitors order.

Private hospitals need to tackle the situation just as much and I'm sure they would beneift from a information campaign.

Earthman wrote:

Given that we know what the causes and spread of the disease is, what do you expect Harney to do exactly short of trying to get people to have a more diligent approach to cleanliness?
You are dealing with human nature there, not resources.

Well spending €4.5 million on a few more staff certainly isn't going to help, an awareness campaign would certainly help, an information leaflet should be given to every patient when they are admitted and posters should be beside every bed informing visitors of the risks. If patients knew the risks they were exposed to when a doctor or nurse touches them they might be more inclined to ask if they have washed their hands. I heard a good idea where doctors and nurses wear a badge saying "it's ok to ask me if I have washed my hands".

I think providing information and educating people would be a very good start to tackling the issue and wouldn't break the bank. Whether we do we can't continue to do nothing!

bonkey

Earthman wrote:

Given that we know what the causes and spread of the disease is, what do you expect Harney to do exactly short of trying to get people to have a more diligent approach to cleanliness?

I'd expect her to do something more than appeal to people's better nature.

When we want people to stop speeding, we do a bit more than rely on appealing to their better nature that they really should slow down. We do that as well, but not in place of coming down hard on offenders.

If a surgeon walked into the OR without washing his hands...what exactly would be done? Nothing, because cleanliness is only really a guideline? I doubt it. Similarly, cleanliness shouldn't ever be relegated to the status of a guideline or recommendation anywhere in a hospital.

And if staff can't follow the rules...fire them.

I'm sure should the govt. gets its ass handed to it via a high-profile case, or even a class-action suit, suing the Irish Health Board for what is effectively gross negligence, the government will discover that not only is there a cr@p-load that could be done, but also that they're outraged that it hasn't been already implemented, and that a full enquiry will have to be held to find who's been letting standards slip.

jc

irish1

irish1 wrote:

That was my point earthman if it was and I posted I'd have had a flood of replies.

I think I answered this for you before with an opinion that young healthy adults don't always give the needs of the health service the priority that perhaps they should untill they are using it themselves or have a parent /relative or friend caught up in it.
Quite often its older people that are at the worst from MRSA.

Many posters are more interested in to put it bluntly living their lives and spending their wage packets and woe be tide any politician that suggests lowering their take home pay or curbing their good times.

Again thats human nature, its always been the way,though its more noticable today because of our affluent society.
On this board by the way,that I have noticed the most busy issue discussed has been in recent years the Iraq war and Bush.
Other world/European order Issues like palestine and the Nice Treaty all got more goat than the health service-again really because people have passion on these issues well before they want to think about illness and their own fragility;something which is usually a distant horizon away-The phrase self invincibility comes to mind.
Theres never much more than 2 or 3 active threads on the front page here on SF and the IRA either whic is reflective of the controversys of the time.

NOW I'm assuming that the purpose of this thread was not to go Waaaah! ye always talk about SF here
So no more of that in this thread PLEASE at all; NOT even a comment on what I've just said as I've said it all before in pm to you anyway-You can take it up in a new thread if you like.

Private hospitals need to tackle the situation just as much and I'm sure they would beneift from a information campaign.

Theres no doubt that they would, but my point was simply that despite them being resourced and staffed better than their public counterparts, they have often as bad a problem.
Theres no accounting for human nature.

Well spending €4.5 million on a few more staff certainly isn't going to help,

no amount of money or staff would help I think.Hospitals by their very nature are full of sick people and heaven for ambient bugs.

an awareness campaign would certainly help, an information leaflet should be given to every patient when they are admitted and posters should be beside every bed informing visitors of the risks. If patients knew the risks they were exposed to when a doctor or nurse touches them they might be more inclined to ask if they have washed their hands. I heard a good idea where doctors and nurses wear a badge saying "it's ok to ask me if I have washed my hands".

That would cost very little and is an excelent idea.The problem you would have to counter first though is motivation and human nature.Tired nurses simply having to rush through some of the jobs is also part of the problem.

bonkey

bonkey wrote:

And if staff can't follow the rules...fire them.
jc

Thats exactly what should be done, like in the example above with the toilets.There is someone responsible for them, the ultimate accountability for a sloppy job is sacking.

The bugs are so virulent though,nothing short of policing every patient contact would do the job.Clearly hospitals in say Germany, Holland and of course Switzerland are doing a better job than we are of that.

I'm wondering also what the unions attitude to a stricter regime would be and to the sackings.

Villain

Earthman wrote:

NOW I'm assuming that the purpose of this thread was not to go Waaaah! ye always talk about SF here

Most certinaly not

Earthman wrote:

Theres no doubt that they would, but my point was simply that despite them being resourced and staffed better than their public counterparts, they have often as bad a problem.
Theres no accounting for human nature.

Well by human nature I presume you mean habits, i.e. not washing hands, that can be changed. It will take a lot of work though and won't happen overnight.

Earthman wrote:

no amount of money or staff would help I think.Hospitals by their very nature are full of sick people and heaven for ambient bugs.

Well one area where I think money would help is overcrowding, I believe we have less public hospital beds now than we had in the 80's. Overcrowding and understaffing certainly help the bug spread, now more staff and beds won't solve the issue but it would be a help.

Earthman wrote:

That would cost very little and is an excelent idea.The problem you would have to counter first though is motivation and human nature.Tired nurses simply having to rush through some of the jobs is also part of the problem.

Yep thats why I said above that more beds and nurses would be a help, if you got them along with the information campaign and education I think you would find a lot more nurses and doctors taking the proper precautions.

I would also like to know how well educated new nurses are about MRSA, training new nurses now to take the proper precautions will pay off in years to come.

Villain

bonkey wrote:

I'd expect her to do something more than appeal to people's better nature.

When we want people to stop speeding, we do a bit more than rely on appealing to their better nature that they really should slow down. We do that as well, but not in place of coming down hard on offenders.

If a surgeon walked into the OR without washing his hands...what exactly would be done? Nothing, because cleanliness is only really a guideline? I doubt it. Similarly, cleanliness shouldn't ever be relegated to the status of a guideline or recommendation anywhere in a hospital.

And if staff can't follow the rules...fire them.

I'm sure should the govt. gets its ass handed to it via a high-profile case, or even a class-action suit, suing the Irish Health Board for what is effectively gross negligence, the government will discover that not only is there a cr@p-load that could be done, but also that they're outraged that it hasn't been already implemented, and that a full enquiry will have to be held to find who's been letting standards slip.

jc

I couldn't agree more bonkey, excellent post.

As regards to taking a case, well I know someone who was advised to take a case but when it was looked into they were told it would cost a lot of money and would be 50/50 as to whether or not they would win and when it was looked into a little further, guess what happened, half of their medical records went MISSING :rolleyes:

Hydroquinone

irish1 wrote:

You know what else bugs me is that when I post on this forum in support of SF I get a tonne of people responding to me, but when I bring an issue like this up it gets next to no responses. :mad:

Look at it another way - political issues are a hot potato so if you post something about SF you'll have all the ususal suspects who agree/disagee with you, all barging in to give their opinions. It gets very heated as anyone who does respond to one of thiose threads has very certain ideas and notions and they want to defend them against the onslaught of the equally opininated people on teh other side. So those sorts of threads are always arguments.

On this, though, who's going to argue with you? did you really think that there would be great swathes of people who'd come on and say
"Cop yerself on, irish1, you are completely wrong - there's nothing wrong with how we're handling MRSA in IReland?"

Did you?

I'm with you on MRSA - the governemtn needs to get its finger out and quick.

I'm presuming that if this 4.5 million for new microbiologists is in the program to eradicate MRSA, then they are going to implement mmicrobiological audits of staff at the patient interface and oversee the deployment of new cleaning protocols; both for staff, visitors and communal areas in a hospital.
However, if these audits of staff behaviour show that there are people who are not following the cleaning procedures between patients, what will happen to them I wonder? The governemtn won't have the cojones to sack 'em as they're afraid of the unions. Teh alleged health service is in a ridculous state in this country.

Sorry to hear about what happened to your father. That is dreadful.