Private Business Intermediaries

Keeping it in the Family

16/11/2012 | By Sharmila Chauhan

The notorious MRSA - or methicillin-resistant staphylococcus aureus - is a type of bacteria that is resistant the commonly used antibiotics. Although one in hundred people carry the bacteria with no health problems, exposure to the bacteria in people who are vulnerable (e.g. the very young or very old) can lead to an infection that is very difficult to eradicate. If MRSA enters the blood via a wound or intravenous site, it can lead to a life threatening infection. For this reason, MRSA in hospitals is really bad news.

MRSA is spread by skin-to-skin contact or through contaminated objects such as bedding. Current methods of eradication include, screening patients before admittance as well as ‘deep cleaning’ methods in contaminated wards.

From January to March 2012 there were a total of 262 cases of MRSA in NHS hospitals nationwide. Highest number of reported cases were seen in the Barking, Havering & Redbridge Hospitals, Pennine Acute Hospitals, Royal Free Hampstead, Royal Free Hampstead, University Hospital of North Staffordshire and Plymouth Hospital. Although there have been a number of improvements in terms of screening and treatment, MRSA still remains a significant challenge to the NHS. Although a number of hospitals do report very low levels or indeed none at all such as the Alder Hey Children's, Barnsley Hospital, Bedford Hospital and Birmingham Children's Hospital, the majority of NHS hospitals are likely to have some degree of MRSA infection at any one time.

Results in the private sector, are quite different. Most hospitals report no MRSA at all. BMI Healthcare which is one of the biggest private hospital groups in the UK, with 65 private hospitals across England, Scotland and Wales plus four private treatment centres, reports no or very low levels of MRSA, attributing this “to the availability of dedicated nursing teams, compliance with appropriate precautions, and single room accommodation, which can be used for isolation rooms if required, enable us to adopt this approach.”

Spire Bristol Hospital results of its latest infections audit – reveal zero cases of MRSA over the past three months. “We are very proud of the fact that, using the measure of 10,000 bed days, we have not had a single case of an MRSA bloodstream infection or a c.difficile infection in our hospital for the eighth successive quarter - and this has now become the principal reason why people choose our hospital for their treatment,” said Louise Daniel, who has worked at the hospital for 22 years. In 2010-2011 CircleBath had zero cases of MRSA bloodstream infections compared to the national NHS Acute Trusts rate of 1.8 cases per 100,000 bed days. (Source Health Protection Agency)

However, new research, published in the Lancet Infectious Medicines journal reports a revolutionary way to tackle the issue in the future.

Researchers examined an MRSA outbreak on a special care baby unit (SCBU) at a National Health Service Foundation Trust in Cambridge, UK. Using samples of the MRSA found on the 12 MRSA infected babies, scientists carried out what is known as a “whole-genome sequencing” this means they identified the genetic code of the bacteria involved. Using this technique they were able to prove that the cases were in fact all related (members of the same bacteria family) and transmission of the infection was occurring within the SCBU, between mothers on a postnatal ward, and in the community. The outbreak was then controlled. But when two months later another case appeared researchers tested 154 members of staff. Eventually researchers were able to identify a member of staff who had inadvertently allowed the outbreak to persist. This member of staff was then treated and the outbreak contained.

"Whole-genome sequencing” may provide a relatively inexpensive method to identify outbreaks of MRSA in the future and could be used by hospitals to identify sources of infection and whether cases are related or new. If this method can be incorporated into NHS and private sector it could lead to a completely new way of tackling MRSA and perhaps other bacterial infections.