INFECTIONS

Welcome to the our infections section which covers some facts on MRSA and C Diff and how you can help keep this to a minimum. The Patients’ Councils objectives are to inform local people about the ever increasing threat to your health posed by the growing prevalence of acquiring either MRSA or C Diff. Where possible we aim to keep local people informed of the progress of this mammoth problem facing us all today.

Back in late 2006 and early 2007 many hundreds of people locally told us of their concerns in relation to local heath care within our hospitals, the top 2 were, and remain, the top 2 concerns “Transport & Hospital Acquired Infections”. We would encourage you to sign-up now for our updates so you can stay informed about what both the Department of Health and your local health care providers are doing to reduce the problem, together with any advice we can give to help protect you and your loved ones when visiting or attending your local hospital.

WHAT IS MRSA

MRSA stands for Methicillin-Resistant Staphylococcus Aureus.

Staphylococcus Aureus is a common germ that lives on the skin and in the nose of healthy people – in fact about one in three people have Staphylococcus Aureus living on their skin without it doing them any harm.

However, it has the potential to be a problem if you become run down, ill, injured or mostly if you have just had surgery. It causes infections if it enters your body, this can happen through open wounds or the instruments needed for your care that are placed in/on your body such as catheters and intravenous drips.

You will be diagnosed with MRSA if your treatment with antibiotics for your infections becomes resistant to Methicillin. This means that Methicillin antibiotic cannot kill the bacteria you have. It is at this point you will need to be treated with other forms of antibiotics that are effective against MRSA.

MRSA IN THE UK

In June 2000, the National Audit Office reported that the number of Hospital Acquired Infections (HAI’s) had reached over 100,000 per year, and that this was costing us, the taxpayer, in the region of £1 billion pounds per year. More worrying is that each year since 2000 the reported number of MRSA cases have increased.

The number of people that can expect to become infected depends on the hospital and nature of treatment, but in some cases this can be approximately 1 in 10 in-patients. A patient with a HAI is up to seven times more likely to die than an uninfected patient. Men are twice as likely to acquire an MRSA type infection than women.

Some of us will contract MRSA which will only result in nothing more than an extended stay in hospital and some extra treatment. However, some of us will not be so lucky, and by contracting MRSA may end up with a disability or even die from it.

There are approximately 5,000 deaths a year reported that are MRSA caused deaths, however many believe the true figure to be closer to 20,000 per year.

It is important to remember that there are huge and positive efforts underway to control the spread of MRSA, and you can find out what is happening in the UK by following the links below:

WHAT CAUSES MRSA

MRSA is generally found within hospitals, although there is growing evidence that it can also be found in places such as nursing and rest homes and in the community it spreads via contact either directly with a carrier, for example by touch; or indirectly, like many bacteria. In most cases, MRSA only poses a threat when it has the opportunity to get inside the body and cause an infection, for example via wounds or surgical scars.

Antibiotics have been used for many years to successfully treat infections, however, they have been overused, and in some cases over prescribed. It is not uncommon for people not to finish their prescribed course of antibiotics and so it is very likely that they will not have killed all the germs that caused the original infection the antibiotics were prescribed for.

The germs that survive within us develop a resistance to the antibiotic and multiply. As more antibiotics are used, the numbers of germs that are able to resist them, such as MRSA, become more common.

CAN MRSA BE TREATED

Yes MRSA can be treated with antibiotics other than Methicillin, but it is becoming increasingly difficult. Therefore, it is vitally important that people take steps to protect themselves by using deterrents such as antiseptic handwashes. If you have the MRSA bacteria on your skin or in your nose, but not the infection itself, hospitals can and do use a special antibiotic ointment to remove MRSA from the nose area plus an antiseptic shampoo and lotion for your hair and skin, as you can still infect yourself and other people.

CAN YOU GET MRSA IF YOU GO TO HOSPITAL?

MRSA is more common in hospitals than anywhere else, however there are more and more cases being reported in local nursing and care homes, and we must remember there is nothing stopping us catching this in our own homes unless we take the proper precautions. We are most vulnerable if we are unfortunate enough to require a stay in an intensive care unit; where currently the greatest amount of infections occurs. It is when we have a surgical wound that the opportunity for MRSA to get into the bloodstream is at its greatest.

PROTECTING YOURSELF FROM MRSA

Although the facts may appear very worrying, we must remember that as patients we have a role to play in reducing the number of people who become infected by MRSA.

The Patients’ Council is committed to promoting the simplest and most effective way of preventing the spread of infections, including MRSA, by handwashing. We are campaigning for visitors, patients, nurses, doctors and general staff to simply wash their hands. When you are in hospital at home or visiting someone in a nursing or care home, you can also help by:

BEFORE GOING INTO HOSPITAL

Use a bactericidal soap and shampoo for a few days before going in to stop the possibility of taking MRSA in with you.

WHEN IN HOSPITAL

• Wash your hands before and after meals.
• Wash your hands before and after using the toilet or commode.
• Encourage ALL visitors to wash their hands before and after visiting you.
• Keep your own supply of alcohol or antibacterial wipes (these are readily available from more high street stores and chemists) by your bed.
• Never walk on the floor in your bare feet.
• Never sit on another patients bed and do not allow visitors, doctors and staff to sit on your bed.
• Ask the staff both treating and caring for you to wash their hands before examining you – there is no need to feel embarrassed about doing this. Do not let anyone examine you without washing their hands in view of you.
• Report dirty toilets, bathroom facilities and bedding to staff whether on the ward or in public areas.
• Try to avoid unnecessary contact with other patients and remember that MRSA can be passed on indirectly so do not share things like newspapers, magazines, books, etc.
• Always ask your visitors not to visit if they are unwell themselves to avoid the possibility of both of you acquiring MRSA.

WHEN IN HOSPITAL OR AT HOME

If your doctor prescribes antibiotics always complete the full course of the treatment as instructed.

SOME KEY FACTS ABOUT MRSA

There is no specific ‘MRSA disease’ as with tuberculosis or typhoid. MRSA infects a range of tissues and body systems giving general often ambiguous symptoms that are common to different infections caused by other bacteria.

Intravenous line infections

MRSA may infect the entry site of an intravenous line causing local inflammation with pus from which the MRSA can enter the blood stream to cause a blood stream infection.

Wound Infections

MRSA is the most common cause of wound infection today after accidental injury or surgery. You can see this as a red, inflamed wound with yellow pus seeping from it.

Superficial ulcers

Pressure ulcers, varicose ulcers and diabetic ulcers (all due to poor blood supply and superficial skin damage) are often sites of MRSA infection.

Deep abscesses

If MRSA spreads from a local site on your body into the blood stream it can lodge at various sites in the body, and can cause one or more deep abscesses far from the original site on your body. This can be painful and cause you to have a high fever, a high white cell count in the blood and signs of inflammation near the infection. If you have this you would be very unwell and may have shivers and low blood pressure. Over a period, the body will suffer a breakdown of tissue, loss of weight with failure of essential organs.

Lung infections with MRSA

MRSA is a rare cause of lung infection except in intensive care units. When a patient is on a ventilator with a tube in the trachea, bypassing their defences of the nose and throat, MRSA can gain entry to the lungs via the tube and cause pneumonia which may be fatal.

Bacteraemia and Septicaemia

MRSA can enter the normally sterile bloodstream either from a local site of infection on your body like a wound, ulcer, abscess or via an intravenous catheter. Severe illness can follow, commonly known as Septicaemia, the symptoms are not specific to MRSA and can be the same for other conditions/bacteria that cause septicaemia. Symptoms can cause high fever, raised white blood cell count, shaking, disturbance of blood clotting with a tendency to bleed and failure of vital organs. This is the kind of MRSA infection that has the highest death rate.