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Page 3 of 9
Friday, 09 September 2005 10:30
BNN: British Nursing News Online · www.bnn-online.co.uk
PATIENTS BRING MRSA INTO HOSPITALS
A study by Oxford scientists has found that a quarter of cases of MRSA bloodstream infections occur in hospital patients who have just been admitted.

Researchers believe the infection had probably lain “dormant” in the patients since a previous hospital stay as the strain they were infected with does not exist in the community.

Tim Peto, who worked on the study, said: "Clearly, clean hospitals and washing hands are important... [but] I suspect, unfortunately, that you have to do more than that."

The University of Oxford team say that the national surveillance scheme, which monitors MRSA bacteraemia (blood stream MRSA) by hospital trust, is failing to address whether the infection is arriving in hospitals from the community.

A study of patients at the John Radcliffe Hospital and The Radcliffe Infirmary (which function as one teaching hospital) and Churchill Hospital between 1997 and 2003 found that new admissions accounted for 49 per cent of total methicillin sensitive staphylococcus aureus (MSSA) cases and 25 per cent of MRSA cases.

Some 91 per cent of patients admitted with MRSA bacteraemia had previously been in hospital, while half had never had MRSA detected before.

Dr David Wyllie, clinical lecturer in microbiology at the University of Oxford, who worked on the study, said: "We do not think these patients had the strain of MRSA which has been seen in the community because the pattern of antibiotic sensitivity was typical of hospital-acquired strains."

Professor Curtis Gemmell, director of the Scottish MRSA Reference Laboratory, said: "The Oxford researchers haven't categorically shown these are not cases of the community-acquired strain of MRSA, because they have not done a molecular examination."

But he added: "A lot of the patients identified as having MRSA on admission to hospital were elderly. And there is a lot of movement of elderly patients between hospital, nursing homes and other healthcare facilities.

"And that's where they are likely to pick up MRSA.

"They are likely to be at a higher risk. But I don't think that message has got through to hospital doctors."


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Monday, 05 September 2005 11:51
BNN: British Nursing News Online · www.bnn-online.co.uk
AMBULANCE CLEANLINESS CRITICISED IN FIGHT AGAINST SUPERBUGS
The health union Unison has attacked the Government for failing to tackle ambulance cleanliness as a measure to reduce the spread of superbugs such as MRSA in the NHS.

The group said that targets, time and money pressures had created a “lethal cocktail” that could allow MRSA to thrive in ambulances.

Unison said that the very vehicles designed to save lives could be spreading deadly infections and called for the implementation and monitoring of cleanliness standards.

An investigation found that many workers were concerned about the potential for infection posed by the vehicles, with some crews still responsible for cleaning their ambulance meaning deep cleaning is rarely carried out.

Karen Jennings, head of health at Unison, said: "It's clear that ambulances are potentially the weakest link in the fight against MRSA and other superbugs and we need national standards to be applied more rigorously and staff properly trained in effective procedures to close this loophole."


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Thursday, 01 September 2005 11:25
BNN: British Nursing News Online · www.bnn-online.co.uk
MRSA RISK LINKED TO GLUCOSE LEVELS
Critically ill patients with glucose in their airways seem to be at double the risk of picking up serious hospital acquired infections, including MRSA, research in Thorax has found.

The authors studied 98 critically ill patients in intensive care who required mechanical help with their breathing for more than 48 hours. The patients were drawn from medical and surgical specialties.

Levels of glucose were measured in their blood samples and lung secretions (bronchial aspirates). The lung secretions were also routinely tested twice weekly, or whenever an infection was suspected, for the presence of harmful bacteria, including methicillin resistant Staphylococcus aureus (MRSA).

Glucose was found in the bronchial aspirates of 58 of the 98 patients, and blood glucose levels in these patients also tended to be higher than those of patients with no glucose in their aspirates. Fifteen of the patients were diabetic.

The aspirates of 87 patients were tested for the presence of harmful bacteria. Aspirates containing glucose were also twice as likely to contain harmful bacteria, and twice as likely to contain MRSA, as those with no detectable glucose.

Patients with MRSA spent seven days longer in intensive care, had higher levels of an inflammatory marker (C reactive protein), and evidence of inflammation on their chest X rays than those in whom MRSA was not found. This suggests that they were more than just carriers of the bacteria, say the authors.

In most cases, the detection of glucose preceded MRSA, suggesting that glucose could have either caused or promoted growth of the bacteria, they add.

Staphylococcus aureus goes through a period of rapid growth during which it uses supplies of glucose. And glucose may also interfere with local immune responses in the airway.

An accompanying editorial suggests that a link between an increased risk of infection and abnormally high levels of glucose is biologically plausible. Too much glucose also tends to give immune cells the equivalent of a "hangover."

But the author cautions that further research will be needed to confirm whether an increase in glucose levels in lung secretions boosts the risk of infection, and whether lowering these levels will cut the risk of infection with harmful bacteria, including MRSA.


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Tuesday, 30 August 2005 10:50
BNN: British Nursing News Online · www.bnn-online.co.uk
NEW DRUG IN MRSA FIGHT
Scientists have taken a step towards preventing future outbreaks of hospital superbugs by developing a drug that destroys their defences.

The team from the University of Notre Dame, Indiana, created synthetic versions of the cephalosporin class of drugs which were found to kill a rare but dangerous strain of MRSA that is known to be resistant to antibiotics and vancomycin – the last line of defence against the superbug.

Cephalodporin works by impairing the bug’s ability to form a cell wall to shield it from antibiotics.

Shahriar Mobashery, who worked on the study, said: "We are the first to demonstrate this unique strategy, which could provide a new line of defence against the growing problem of antibiotic resistance."

Mark Enright, an MRSA expert at Imperial College London, said in The Guardian: "If vancomycin resistance becomes common, it's a nightmare scenario in many ways. Thousands already die from MRSA and vancomycin is really the drug of last resort to tackle the infections.

"If it stops working there's not much else to turn to."


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Tuesday, 23 August 2005 09:28
BNN: British Nursing News Online · www.bnn-online.co.uk
NURSES OUTFIT BAN
Health bosses from the Sunderland Teaching Primary Care Trust have banned district nurses from going into shops and commercial premises in uniform, as part of the fight against superbugs such as MRSA.

The new ruling will apply to the 300 district nurses who work in Sunderland who visits patients in their homes.

Sunderland Teaching Primary Care Trust's nurse consultant Margaret Kennedy said: "Confidence in our service is being shaken every time they see a nurse in a public place and worry and are anxious about what they actually could be carrying on their uniform.

"And I think we have a real issue in the NHS, a real desire to reduce health acquired infections.

"And if we know that uniforms carry bacteria, then what is the justification for us not to take this action?"

Gill Hale, from Unison, said they were supportive of the general principle behind the move.

She said: "Obviously we are committed to the eradication of infection and from that point of view we have got no objection in principle.

"But practically speaking there are some problems here for nurses working in the community and we would like to see some attention given to solving those problems.

"It can be very difficult if you need to get a sandwich at lunchtime, or something like that, to be able to change out of your uniform whilst you are out in the community, back into it".


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Sunday, 21 August 2005 09:59
BNN: British Nursing News Online · www.bnn-online.co.uk
NEW TEST SHOWS MRSA RISK IN PATIENTS
Scottish scientists at drugs giant Johnson & Johnson's Edinburgh branch Ethicon have developed a test that can predict whether a wound will become infected, making it possible to stop superbug infections before they begin.

The team have come up with a 'dipstick' test that looks for the early signs of bacterial infection.

The new technique measures the levels of biological molecules associated with an immune response by the body to bacteria in a wound.

By measuring the presence of these molecules, doctors can tell if the wound is likely to become infected.

The researchers found wounds that later became infected had massively elevated levels of these 'marker' molecules days earlier.

Breda Cullen, who invented the method, claims that it would also reduce the need to use antibiotics to fight superbugs such as MRSA by stopping them before they cause an infection.

She said: "If clinicians could respond to wound infection as early as possible the infection could be treated topically as opposed to having to use antibiotics.

"The use of the invention is envisaged as being most useful in predicting or diagnosing clinical infection of a chronic wound such as ulcers and sores".


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Thursday, 18 August 2005 10:20
BNN: British Nursing News Online · www.bnn-online.co.uk
MRSA: IT'S SAFER AT HOME
Consultant Sherwood Burge a senior doctor at the Heartlands Hospital, Birmingham has told an inquest that a patient was discharged from the hospital because she was safer at home because of the risk of MRSA.

Professor Burge said there was a "substantial risk" of MRSA infection at NHS hospitals.
He described the city hospital as "not a terribly safe place to be”.

Giving evidence at Wednesday's hearing in Birmingham the professor added: "It's usually safer at home”.

Tony Field, from the Birmingham-based MRSA Support, backed Mr Burge's statement.

He said: "He's absolutely right. Some hospitals are better than others (but) anyone in hospital is at risk of MRSA and severe risk of other hospital acquired infections”.

Gulnar Qureshi, 44, from Acocks Green, Birmingham, died from blood clots on her lungs after being sent home twice from the hospital.

Mrs Qureshi, was first admitted to the hospital after collapsing at the funeral of a nephew on 28 January, this year. She was readmitted to the hospital on 16 February, and again on 24 February, when she died. A pulmonary embolism was diagnosed on the third visit. Her family has asked why doctors discharged her twice and did not diagnose her with a pulmonary embolism until her third admission.

Professor Burge, said blood clots to the lungs were one of the most difficult diagnoses to make, particularly if a patient was not showing typical symptoms.

He told the court: "I think you need to be a clairvoyant to make a diagnosis of pulmonary embolism on the first admission.

"We thought she was getting better. We thought any further investigation could happen more safely as an out-patient”.

He added: "I think we have tried hard and we clearly got it wrong. It clearly had disastrous consequences”.

The doctor denied any gross negligence on the part of medical staff.


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Monday, 15 August 2005 10:17
BNN: British Nursing News Online · www.bnn-online.co.uk
LAYERED APRON' MAY CUT MRSA
Kuldeep Bangal, a London trauma surgeon has designed an apron that has layers which can be peeled away like an onion hoping this could be a simple way of cutting hospital infections.

Miss Bangal, who has patented her idea and prepared a prototype, said: "Staff compliance can be a real problem.

"It's not that staffs aren’t concerned about hospital infection.

"But it can take 40 seconds to take an apron off and put another one on.

"For someone like a phlebotomist [who takes blood], or a nurse moving from patient to patient in an intensive care unit, that can take up a lot of time.

"It works out at around five minutes for every 10 patients”.

She said hospitals currently had apron-dispensers - but these could be away from patients, or empty, and staff may not have time to seek out new supplies.

Miss Bangal added: "The alcohol gels show if something is easier to do, more people will do it, and infection rates will come down.

"This apron is using that precise principle.

"It's multi-layered, like an onion, so you pull off the top layer and are left with the layers underneath”.

Miss Bangal said it was known that clothes, such as nurses' uniforms could carry infections.

But she said it was not known how much of a risk the presence of a bug such as methicillin-resistant staphylococcus aureas (MRSA) on a cuff actually was, and whether it could get into a wound from clothing.


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Sunday, 14 August 2005 09:41
BNN: British Nursing News Online · www.bnn-online.co.uk
A HOSPITAL WITH ONE OF SCOTLAND'S WORST MRSA RATES HAS BEEN BRANDED "APPALLING"
Woodend Hospital in Aberdeen, Scotland, a hospital with the worst rates of MRSA has been branded "appalling".

The Sunday newspaper Scotland on Sunday already revealed that the hospital had one of the worst known MRSA rates in the country, with one in every 62 patients catching the bug last year.

Now the latest figures show that the rate has soared in 2005, with 30 more patients being infected in the first seven months of the year, compared with 2004.

Health minister Andy Kerr demanded that the hospital takes immediate action to improve infection control. He said: "If this is true, it is completely unacceptable.

"We take the issue of tackling healthcare associated infection very seriously and this is why we have invested £15m in a comprehensive infection control campaign."

Aberdeen SNP MSP Richard Lochhead added: "Although I appreciate the pressure and conditions staffs at Woodend Hospital are required to work under, patient safety has to be the top priority”.

NHS Grampian is now believed to be facing a string of legal actions over conditions at Woodend from the relatives of patients.

Tony Fields, from MRSA Support, said: "This is depressingly typical of what is happening in hospitals all over the country. This kind of poor infection control is outrageous”.

A spokeswoman for NHS Grampian defended the hospital's hygiene standards but urged patients with complaints to notify staff immediately. She said: "Woodend Hospital does not have designated isolation rooms. Single rooms are often used when available and if appropriate”.


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Friday, 22 July 2005 09:11
BNN: British Nursing News Online · www.bnn-online.co.uk
OAP AWARDED DAMAGES
Mrs Kitty Cope, 87, who contracted the superbug MRSA at The Princes of Wales Hospital in Bridgend, has been the first patient to be awarded "substantial damages".

Mrs Cope contracted the infection after a hip replacement operation in February 2001. The infection meant her new hip had to be removed.

She took legal action against Bro Morgannwg NHS Trust, which runs the hospital, claiming it had allowed her to contract MRSA by failing to implement its policies and treat the infection appropriately.

The Princes of Wales Hospital accepted it had not followed its own guidelines on infection control in her care.

The case was settled out of court. Mrs Cope, who was left permanently disabled, intends to use the award to install a walk-in bath and a stair lift at her home.

She said: "I hope that the hospital will learn from their mistakes and in future will follow its own policies and ensure that this does not happen to anyone else”.

Her lawyer Stephen Webber, of law firm Hugh James, said: "This is a landmark settlement, which will make it possible for injured claimants to obtain their rightful compensation if they suffer injuries following the contraction of MRSA.

"This is a wake-up call to the hospitals to ensure that they have adequate infection control policies in place.

"If all hospitals adhere to those policies, infection control specialists advise that we should then see a reduction in the rates of MRSA infections”.

Bro Morgannwg NHS Trust said in a statement: "The Trust has accepted that there were some failings in relation to the care provided to Mrs Cope at the time and is pleased a settlement has now been reached”.


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