How safe are you in an Irish hospital?

national | miscellaneous | news report Monday December 27, 2004 23:48 by Seán Andrews seanpandrews at hotmail dot com

The scandal of MRSA

Irish hospitals are no longer safe places in which to be ill. Incidence rates for infection by the superbug MRSA are at an all time high and preventive measures are proving ineffectual.

While media attention has been focused recently on overcrowding in the Accident and Emergency Departments in Irish hospitals a much more serious issue is getting little attention. It is difficult enough to get into an Irish hospital, but what happens when you are in there can be particularly bad for your health. Irish hospitals are currently being stalked by a number of superbugs, any one of which can make you extremely ill, or even kill you.

Back in the days before antibiotics, hospitals had to be kept spotlessly clean. Nurses and doctors had to have a sharp eye to good hygiene because, if a patient got a serious infection, little could be done to save his life. Then came penicillin and many of its derivatives, whose curative powers were so effective that most infections were no longer a problem. Of recent years, however, bacteria have mutated into forms that are highly resistant to antibiotics. Many hospitals now harbour such strains.

One of these, MRSA (methecillin resistant staphylococcus aureus), has become a very serious problem in Irish hospitals. This bacterium, which can live harmlessly on the skin or in the nose, is no threat to a healthy person. However, a patient who has undergone extensive surgery or whose immune system is weakened because they are very old or disabled can, if infected, become seriously ill. The bad news is that less than a handful of effective antibiotics are available to treat MRSA infection, and the there is a real fear that even these will shortly begin to fail.

Irish hospitals have one of the highest incidence rates of the most serious form of MRSA infection. In answer to a Dail question on 7 April 2004 the then Minister for Health and Children, Mr Michael Martin, revealed that 41.7 per cent of bacteraemia, or blood borne infections, in Irish hospitals were attributable to MRSA. This places us just behind Britain which, at 44 percent, has the highest rate in Western Europe. The Nordic countries have, by comparison, a rate of around one per cent.

In the UK, the National Audit Office reports that hospital acquired infections cost the British National Health Service a billion pounds sterling a year and are the cause of 5000 deaths. If MRSA infection is a serious problem in Britain, and hospital laboratories in Ireland are recording the presence of resistant bacteria to close on British rates, the logical conclusion is that people in Ireland are certainly becoming gravely ill and dying from MRSA infection.

Yet there are no official mortality figures available. This means that deaths from MRSA infection in Ireland remain isolated family tragedies and do not enter the public domain in a statistical form that might trigger general alarm and increase the pressure for action.

However, the health authorities know there is a crisis. And what is being done about it? Very little. As far back as 1995 the state issued basic guidelines about the need to maintain good hygiene procedures in hospitals in order to curb the rise of the superbugs. Careful hand washing by medical and nursing staff and disinfecting wards and equipment on a systematic and regular basis is known to be highly effective in curbing the spread of MRSA. Prevention is not difficult if simple rules are followed, as other countries have clearly shown. Yet Irish infection rates have continued to rise.

In 1999 the Minister commissioned the National Disease Surveillance Centre to devise a strategy for the control of antimicrobial resistance in Ireland (SARI). This strategy was launched in June 2001 and was backed by 12 million Euro of special funding. However, because the Irish health service is in such disarray, these recommendations have only been patchily implemented across the various health boards. Meanwhile patients on the wards are continuing to get sick and Irish families are losing loved ones to infections that are preventable.