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Moya Stevenson and Tom Snowball relate their experiences as two survivors of the hospital superbug live with the panel of experts
Transcript of programme
GP Dr Mark Porter - This morning we will be looking at MRSA meeting a man Tom Snowball who caught the infection...
Dr Raj Pesaud - I'm looking forward to that item because I'm wondering whether we are reaching the end of the antibiotic era when our kids may not have a reliable treatment for infections just like our grandparents didn't have.
Dr Mark Porter - well we ill be putting the risks into perspective and taking a look at what you can do to protect yourself.What would you say if I told you its quite likely you are sitting at home with MRSA bacteria in your nose, well that could well be the case because at least 1 in 30 of us can carry MRSA without knowing, shocked?Well if so many of us carry it harmlessly, why is it so dangerous in our hospitals?In a moment we will be meeting an expert who is here to tell us the facts we should all know, but first let's meet a man who had the infection, Tom Snowball.
Tom, you went into hospital for a big operation, a heart operation...
Tom - for a triple by-pass..
You should have been home, what within a week or two of that?
Tom - seven to ten days...
But it didn't go according to plan did it?
Tom - Seven weeks.
Tom - I went in, had the op.First two weeks I was unconscious, didn't remember a thing, and my family were taken to one side and told that I had the bug... MRSA.... I had been swabbed prior to going in, and it came back negative...
So you weren't carrying the bug yourself, so you contracted it, picked it up from somewhere else in hospital?
Tom - It could have been Intensive Care, High Dependency or Theatre...
So they don't know where you caught it, but you caught it, but what actual problems did it cause for you then, obviously you were very ill if you don't remember the first two weeks...
Tom - I lost weight, I lost five and a half stone.I had to change all my wearing apparel, going down two sizes, from a 46 to a 42....
But while you were in hospital they had to reoperate as well, as the infection got quite deep into the wound...
Tom - Four times I had to be opened up.My chest opened, the third time I gave the doctor a hand to put a zip in (joke).
That was presumably to try to rid of all the pus and the debris...
Tom - I came out the last Friday in March.When your family were told that you had MRSA, that's a term that often engenders a lot of fear, people think superbug and all this sort of stuff, what did they think, they were obviously very worried about you?
Tom - my daughter said I was a very very ill man for the first two weeks after the operation.
So instead of going home in the second week, you were another five weeks in hospital, how long ago was that now?Tom - 2004... Right so that was three years ago, how have you been since?
Tom - Well I had to have my chest opened again in the September, not because of the MRSA though was it?
Tom - I had a third nipple on my chest, the problem was it kept filling up with fluid... But they managed to eliminate the infection eventually with the antibiotics...
Tom - yes &pounf4,000 worth of very special antibiotics, one month's supply.
Well Tom, thank you very much for coming in to talk to us.... we are going to hear from another person who had MRSA, but first please welcome MRSA expert and consultant microbiologist Dr Gopal Rao.
Gopal, you heard Tom's story, you hear a lot of dramatic stories about MRSA and people are very scared by the idea of picking it up in hospital, but I think it is very important that we should put the risks into perspective.Most people who go into NHS hospitals don't go anywhere near MRSA and don't pick up the infection.What sort of pick up rate is there in your hospital?
Gopal - In our hospital people who come in through emergency admissions, they are the ones who have MRSA because we don't have the time to check them often... Appendicitis, heart attacks, those kinds of people... Very ill heart attack, whatever else... We have about 15,000 admissions a year, adult emergency admissions, children often don't carry MRSA, they don't pose a problem.Amongst the adults we have got 15,000 admissions a year coming in the A&E department and something like anything between 5 and 7% of those people who are screened at the time of admission are carrying MRSA...
So that's as many as 1 in 10 / 1 in 15....
Yes... They are carrying the bacteria, bringing it in rather than contracting it in hospital... of course you must remember that those who have come into the hospital are not necessarily representative of the entire population, I mean 15% of the people who come into our hospital have been in the hospital in the previous 12 months.
If I go into your hospital as a patient for a procedure, I'm going in to say have heart surgery for instance, what are my chances of contracting MRSA while I'm in there, you must know?
Gopal - Very very little...
Can you give me a rough guide?
Gopal - Less than 1% 0.5% and that is an inherent risk that is always there with any surgery that you may get an infection...
So that is198/200 patients will go in without any problem at all....
Gopal - Absolutely, we actually have something we talk about as patient days, ours is a 500 bedded hospital and we have 160,000 patient days spent in the hospital and we have a very small handful of infections that are actually picked up, such as MRSA or some other infection.
When you get the infection it can be very nasty, I think this is something that people might find difficult to understand, how can the bacterium live in your nose and not cause any trouble and yet if your very ill, like Tom.
Gopal - That is a conundrum that we face, all of us carry bacteria on our bodies, in fact, they are essential.If we eliminate the bacteria there is another superbug that people are dealing with - Clostridium Difficile, the problem exists because you have eliminated your friendly bacteria, so we need a friendly bacteria, but we don't want a nasty bacteria to become our friendly bacteria.
The name is Methicillin resistant Staphylococcus aureus, basically it's a bacterium that's resistant to most of our commonly used antibiotics, but it is treatable...
Gopal - Absolutely, but the reason why we are always very careful is one thing is the antibiotics that are able to treat it are either toxic or very expensive, and you have the expense of the money available as Tom has just said, a month's supply costs £4,000.Putting it in the scheme of things but otherwise if it was not MRSA it would cost 40 pence.There is that scale of difference in terms of the cost of the drugs, some of the drugs are quite toxic and so we would like to avoid a person getting an MRSA infection.
And so you picked up the infection in the hospital, what did you notice, how did you know there was a problem?
Moya - Well at first you come home and obviously you are a little bit sore, a little red which is expected after any surgery, and then unfortunately within 48 hours, the scar had actually burst open and I was obviously taken back into surgery the following week, and found this mass underneath the scar that was full of MRSA.
We have actually got some pictures of your scar, if people are put off don't look.We have a close-up showing in more detail, so what should have been a little tiny scar has burst wide-open, and that's the infection. So what happened after?Moya - again obviously the site of the hole was around about 9 centimetres wide and 5 centimetres deep, so you can imagine that takes an awful long time to heal from the inside to the out, so in total what should have been 4-6 weeks maximum in recovery led to a 6 months for the hole to close.
And were you screened when you went into the hospital, I know you picked it up when you were in hospital, but were you tested to see if you were carrying it?
Moya - unfortunately at that time the hospital did not do prescreening for surgery, however discovering the only part of the anatomy that tested positive for the bacteria was the actual surgical site, at the same time all the swabs taken from my body were actually negative for even Staphylococcus aureus.
Moya thank you very much.Gopal.We often read in the headlines that it's all about dirty hospitals, the MRSA problem, but it's a lot more complicated than that, the bacterium, rather catching it from dirty wards or floors.It's a condition that's spread from person to person, nurses are spreading it, patients are bringing it in themselves.Absolutely.What are you doing about it?
Gopal - I think I believe in screening people as they come in so it is far easier to control the infection if you know who is carrying it.Rather than have somebody who is carrying it but don't know about it.
In a hospital, you're a doctor, much stricter hygiene?
Gopal - Absolutely. Also we are in a fortunate position of getting one of those PFI new builds, new hospital, a third of our ward stock is now single rooms, so that's very helpful.
Right very briefly do you think this is a battle we are winning?
Thank you just to sum up here's some top tips to help avoid infection:
Wash hands, you the patient your visitors, and make sure any doctor or nurses washes their hands or wear gloves before touching you
Bathe in antiseptic, If you are going in for a planned operation, you can wash your skin to remove any bacteria, you can ask your pharmacist about a suitable product
Pre-op screening, ask your surgeon if you are going in for planned surgery about pre-operative screening, a lot of surgeons now do it routinely
Postpone surgery, if you are found to be carrying MRSA ask your surgeon if your operation can be postponed until you've got rid of it
(c) MRSA Action UK June 2008