MRSA Scandal

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Louise Thomas

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Every year 5,000 patients in hospitals in Britain die from an infection acquired after they were admitted.

Up to 100,000 more - almost one in 10 in-patients - endure extended illness, pain and suffering caused by bugs they contract in the place where they came for a cure.

The number of deaths exceeds that from road accidents, and that from drugs and HIV/Aids combined. Our rate of infection is among the highest in the world, above that of Australia, Denmark, Norway, the Netherlands and Spain. It costs the NHS more than £1bn a year.

Today, the Government will launch its latest crackdown on poor hygiene to cut the rate of hospital infections, of which the worst is MRSA (methicillin-resistant Staphylococcus aureus). Lord Warner, a health minister, will launch a guide for hospitals, setting out how every part of the institutional environment should be cleaned. Hospitals are to be ranked in a league table on food standards and cleanliness.

The Tories accused the Government last night of window-dressing and claimed this was the 22nd initiative on hospital infections announced to cut the death toll since the Government came to power. Michael Howard, the Conservative leader, has made action on MRSA one of the Tories' 10 priorities for the general election. In an article today in The Independent, he describes how his mother-in-law died of the disease.

The Tory health spokesman, Andrew Lansley, said: "It is a national scandal. Over the last seven years, deaths from MRSA have doubled. It has been clear for years that the actions required included closing wards and giving patients the right to refuse hospitals or wards where there is infection. Nurses should have the power to stop admissions to wards."

For people like Jacqui Munro, the measures are too late. Days after returning home from hospital in Lanarkshire with her first child, born by Caesarean on 21 June, she was rushed back after a black rash appeared around the wound. She spent 11 weeks battling against infection with MRSA and other bugs, but she died in September.

The best way of saving people such as Mrs Munro is with hygiene - yet simple procedures are still not being practised. One in three people naturally has staphylococcus infections on their skin, which is not a problem in fit, healthy people. But since the early 1990s, there has been a sharp growth in staphylococcus infections resistant to methicillin and other antibiotics. Today, 40 per cent of Staphylococcus aureus bloodstream infections are caused by MRSA.

When these organisms get into the blood of people who are sick or elderly through a wound or a needle inserted in a vein they become seriously ill because their immune system is already weakened. They are hard to treat because the organism is resistant to antibiotics. Yet the infections could be sharply reduced - this is the key point - by ordinary measures such as washing hands. To improve hospital hygiene the Government's chief medical officer ordered every NHS trust to appoint a director of infection control last year with responsibility for cutting deaths and illness caused by superbugs. Sir Liam Donaldson ordered the move after acknowledging that five years of advice and guidelines had failed to work.

"The message is, there will be no more Mr Nice Guy in the fight against hospital-acquired infections," he said. "We are going to get much tougher and more aggressive."

However, six months later in July this year an investigation by the National Audit Office found rates of infection were still rising. Official figures published by the Department of Health showed overall infections caused by MRSA increased from 7,384 in 2002-03 to 7,647 in 2003-04 - a rise of 3.6 per cent.

The highest rates were seen in some of the country's most prestigious hospitals. Guy's and St Thomas' NHS Trust in London had the highest MRSA rate at 0.45 cases per 1,000 bed days, followed by Addenbrooke's in Cambridge, with a rate of 0.38.

The NAO blamed chronic failures by the NHS to deal with the problem and said that, four years after its first report, many of its original recommendations had still not been implemented.

"The war against hospital- acquired infection must be pursued on many different fronts, including a more robust approach to antibiotic prescribing and hospital hygiene, instituting a system of mandatory surveillance and persuading all NHS staff to take responsibility for effective infection control," said Sir John Bourn, comptroller and auditor general of the NAO.

Many of the infections occurred because sick patients were more vulnerable to infection, the NAO said, but it estimated that 15 per cent of cases were preventable by better practices. That is equivalent to 750 deaths a year which could be prevented if more stringent regulations were in place.

MRSA is caused by overuse of antibiotics, especially by the agriculture industry, where they are added routinely to animal feed as growth promoters. Bacteria resistant to the drugs grow and multiply, by a natural process of evolution, and the more widely the drugs are used the greater the opportunities for resistance to develop.