The key is to identify and isolate the infected patients

Jeremy Laurance
Tuesday 22 March 2005 20:00 EST
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Sloppy hygiene is one possible cause of Luke Day's unexpected death.

Sloppy hygiene is one possible cause of Luke Day's unexpected death.

The lethal bug that found its way into his bloodstream almost certainly entered via the umbilical cord after it was cut. Investigations by the hospital have failed to establish the source of the infection but it is possible it was carried by a member of staff or the family, who later tested negative.

MRSA is brought into hospital by staff, visitors and patients, carried on their skin. Colonies of the bacterium are difficult to eradicate and are transmitted in the air and by touch. Personal hygiene is crucial.

Harvey Marcovitch, spokesman for the Royal College of Paediatrics, said: "The public have it wrong on MRSA. Most cases have nothing to do with the dust on top of the cupboards or under the beds. Much more important is that doctors and nurses should wash their hands between each patient. Some are better at this than others."

Cases of MRSA infection in children are rare because they tend to be fitter and stay in hospital for a shorter time than most patients.

In 2004 there were 52 bloodstream infections in the under-fives, according to the Health Protection Agency, compared with a total of 3,519 in all patients in the six months from April to September.

Luke's father, Kevin Fenton, accused the hospital authorities of covering up the cause of death, which the hospital denied. But in the past, doctors have been reluctant to include MRSA on death certificates because it indicated possible shortcomings in care. In the past, the true toll from MRSA-linked deaths is thought to be higher than official figures have shown.

The problem of MRSA has become a political issue because of Britain's poor record compared with other European countries. The Government released figures earlier this month showing a 6 per cent fall in bloodstream infections for the six-month period from April to September 2004, compared with a year earlier. The Tories said the figures failed to tell the full story and accused Labour of "pre-election trickery". The number of cases is expected to rise in the period from October 2004 to April 2005, because it covers the winter.

The figures, collected by the Health Protection Agency, showed that Ipswich hospital recorded 23 bloodstream infections with MRSA, the most serious kind, in the six months from April to September 2004. The infection rate for the hospital was 0.18 per 1,000 bed days, putting it in the middle of the range for England's 173 NHS trusts.

MRSA carried on adults' skin usually causes no problems. It is only when the bug infects a wound or enters the body via the catheter of a patient whose immunity is weakened that it becomes serious.

Staphylococcus aureus (SA) is a common bacterium but the methicillin-resistant strain (MRSA) cannot be treated with common antibiotics. It is harder to treat, requiring an extended stay in hospital, and may be lethal.

A crucial defence against MRSA is to identify infected patients and treat them in isolation units where they cannot pass on the infection. The Government announced this month a new rapid, swab technique to identify patients coming into hospitals with MRSA within two hours rather than several days. The test costs £25 to £30 and will be piloted in two hospitals. Doctors are confident it will work, but say reducing infection rates will depend on how hospitals deal with high-risk patients.

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