Derek Butler, Chair
Email: derek.butler@mrsaactionuk.net
Telephone: 07762 741114
Archived articles March 2007-March 2008
For the latest Press Releases from MRSA Action UK visit the Opinion Formers Website at:
Penicillin bug genome unravelled
Dutch researchers have decoded the DNA sequence of the fungus which produces penicillin.
It is hoped that uncovering the genome of Penicillium chrysogenum will boost the development of new antibiotics to overcome problems of resistance.
The findings come just in time for the 80th anniversary of the discovery of penicillin by Sir Alexander Fleming.
Full details of the 13,500-gene sequence will be published in Nature Biotechnology in October.
Penicillium chrysogenum is used in the production of antibiotics such as amoxicillin, ampicillin, cephalexin and cefadroxil.
|
If we understand the genome we might be able to manipulate the genes - Professor Hugh Pennington |
Its use in killing bacteria was discovered in 1928 after mould spores accidentally contaminated a petri dish in a laboratory.
Further work discovered it was safe for use in humans.
About one billion people are thought take penicillin every year around the world.
But antibiotic resistance is becoming an increasingly serious problem, as for example has been shown with MRSA.
Surprises
Researchers said in addition to combating resistance, the genome sequence may also help to improve the manufacturing of antibiotics.
Dr Roel Bovenberg, a researcher at DSM Anti-Infectives, the biotechnology company behind the genome sequencing, said the four-year project had thrown up "several surprises" which they were investigating further in collaboration with academics.
"It provides insight into what genes encode for, know-how in terms of manufacturing and new compounds to be identified and tested.
"There are genes and gene families we did not think would be involved in biosynthesis of penicillins - they weren't on our radar so that is our follow-up work."
Professor Hugh Pennington, an expert in bacteriology at the
"If we understand the genome we might be able to manipulate the genes."
He said traditionally antibiotics had been found just from looking at what fungi produce, but in recent years scientists had been trying to modify existing treatments.
"All the easy targets have been hit by one drug or another so it's proving very difficult to find new compounds and we're going to need some lateral thinking.
"If the genome helps to do antibiotic development quicker, then that can only be a good thing."
Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/1/hi/health/7638379.stm
Published: 2008/09/29 23:05:15 GMT
Copyright: BBC MMVIII
Published: 29/08/2008
Scientists at two Scottish universities have made a historic breakthrough which could be the first major step towards wiping out the MRSA and Clostridium difficile superbugs.
Results of research carried out at
The team has been studying how tiny openings on the cell walls of bacteria open and close to release pressure.
If these openings did not operate properly, pressure would be allowed to build up, and the bacteria would explode and die.
The researchers say that, by controlling the openings, it would be possible to slow the growth of bacteria - or even kill them.
Last night, Health Secretary Nicola Sturgeon welcomed the discovery, while the UK's leading microbiologist Hugh Pennington said it "opened new territory" in the fight against antibiotic-resistant bugs.
Recent figures from the Scottish Audit of Surgical Mortality show deaths from superbugs such as MRSA and other similar bacteria continue to rise across
In 2006, hospital-acquired infections were a contributing factor in 422 deaths, up from 401 in 2005. Of these, 398 patients had an operation, up from 380.
Just last month, NHS Grampian was ordered to launch a fresh inquiry into patient deaths linked with the C diff superbug.
Experts are worried about the number of fatalities at both Aberdeen Royal Infirmary and the city's
In a paper published today in the premier journal Science, the researchers describe for the first time the mechanism of a bacterial pressure-release valve, or channel, which helps protect bacteria inside the human body.
The findings of the two university's teams could now pave the way for new drugs to combat superbugs by controlling these channels.
Professor Ian Booth, who led the team at
"Channels in bacteria perform key roles in cell survival," he said. "We have been able to show how this channel opens and closes.
"Understanding how they work will play a major role in inhibiting the survival of bacteria and could have applications as basic as cleansing hospital equipment and wards or helping to make food safer. These channels are found in MRSA and C difficile and this knowledge has not yet been exploited. The future path is to find new chemicals and processes that exploit the importance of the channels to these bacteria."
The work is the culmination of molecular studies at
Professor James Naismith, who co-ordinated the
"Not only is this a major step forward in scientific understanding of a fundamental process in biology, but it paves the way for the development of new drugs against bacteria.
"It is vital to the bacteria that the channel fully closes and only opens at the right times as mistakes either way would be fatal.
"New chemicals designed to force channels to stay open or shut are likely to kill, or at the very least, greatly slow down the growth of bacteria.
"Slowing down the growth gives the body's natural defences time to tackle its bacterial invader."
Last night, Aberdeen-based microbiologist Hugh Pennington welcomed the discovery.
He said: "There is an urgent need to think outside the box to tackle antibiotic-resistant bacteria, and this research gives a new direction for the drug discovery people to target their work. This is a very elegant piece of work."
http://www.pressandjournal.co.uk/Article.aspx/811682
Coming to
By Daniel Martin
Last updated at 10:53 PM on 28th September 2008
A flu virus more deadly than any seen in two decades is threatening
The strain originates in
Called Brisbane H3N2, it is so virulent that health chiefs have had to change the make-up of flu vaccines to deal with it.
It affects three times the number of victims hit by other strains, with many deaths resulting from pneumonia.
Viruses from the southern hemisphere strike in their winter months - our summer - and tend to travel north for our winter.
And although that did not happen after Brisbane H3N2 ravaged
Hugh Pennington, professor of bacteriology at
'Sooner or later we will have a big outbreak, and the more cases there are, the more deaths there will be.
'There is no doubt that elderly people are more at risk. It can tear through an old folk's home and cause a lot of harm.'
The last major outbreak in
The Australian flu outbreak affected even fit young adults, and
Experts speculated that several winters of mild flu had left the population with little immunity. Last year the Australian inventor of the flu vaccine, Dr Graeme Laver, said the outbreak in his country meant
'You could have a really severe epidemic. Thousands will be ill and many will die.'
The World Health Organisation and Sanofi Pasteur, a vaccine manufacturer, have combined the
FACT FILE
- Six influenza pandemics have struck
- Flue, like the common cold, is high contagious because it is spread by ?droplet infection?, through coughs and sneezes
- The three types of flu, known as A, B and C, all attack the respiratory tract. Antibiotics offer no defence
- Last month the body of Sir Mark Sykes who died of flu 90 years ago was dug up in the hope his DNA could help treat bird flu. The British diplomat died in
- The Spanish flu pandemic of 1918, which killed more than 50million worldwide, is thought to have originated in the
Professor Bruno Lina, head of the National Influenza Centre in Lyon, France, said: 'The upcoming season is notable in the sense that among the three new vaccine strains, there is one that has proved to be very virulent in Australia.
'This further reinforces the importance to comply with health authorities' recommendation for seasonal flu vaccination.'
Influenza comes on suddenly and is characterised by fever, tiredness, dry cough, sore throat, nasal congestion and an aching body. Many victims fail to seek remedies, spreading the disease further.
In
Residents of care homes are also offered the vaccine because a virus would spread very quickly among them. Health workers are routinely vaccinated because of the dangers of them passing flu on to vulnerable patients.
The Department of Health is considering offering the jabs to pregnant women as well.
Dr Laver warns, however, that the vaccine cannot always be relied on. He wants the Government to make drugs such as Tamiflu, which is taken after flu symptoms strike, to be available over the counter.
A Department of Health spokesman said: 'Preventing and treating flu is a serious issue, and the NHS is well prepared. Seasonal flu vaccination is available free to everyone in the at risk groups.
'
http://www.dailymail.co.uk/health/article-1063737/Coming-Britain--Australian-flu-virus-killed-hundreds.html#
Brown sends thankyou letter to all NHS staff as MRSA infections drop 57 per cent in four years
By Jenny Hope
Last updated at 12:13 AM on 19th September 2008
Gordon Brown yesterday congratulated Health Service staff on a 'dramatic fall' in MRSA infections.
In an open letter, he said the Government had finally met its target to halve the number of infections since 2004.
The Prime Minister said the 'tremendous achievement' of a 57 per cent overall reduction in cases was due to NHS staff who had also managed to produce significant falls in waiting times.
MSRA infections have fallen by a third since 2007, which the government says is because of a hospital 'deep clean' campaign
The message was put out via several websites used by NHS staff and emailed to directors of nursing, senior managers and communications staff who are expected to pass it on to staff.
However, campaigners attacked Government spin over the way the target was set and for bringing forward the 'good news' announcement before next week's Labour Party conference.
The independent Healthcare Commission also criticised variations between trusts, with some falling far short of the reduction claimed by the Government.
The MRSA target was set by then health secretary John Reid who pledged by 2008 to halve the 7,700 bloodstream infections recorded in 2004.
Last year the Government interpreted this to mean the quarterly average for 2004 of 1,925 would have to be 963 or lower.
In the first quarter of this year there were 969 infections - just outside the target. But Health Protection Agency figures released yesterday show from April to June this year the number of cases fell to 836, which is 57 per cent lower than the quarterly average of 1,925 in 2004.
Mr Brown also said there had been a 32 per cent fall in C.diff cases over the last year, although latest figures will not be released until next month.
The Prime Minister announced at last year's Labour Party conference that every NHS hospital in
Anna Walker of the Healthcare Commission said the figures were a 'big success' in the war against
MRSA, but warned of variations in the performance of trusts.
She said: 'There are some trusts that don't have the necessary systems to fight outbreaks if they do occur and some are falling far short of targets to reduce rates of MRSA.
'We should also remember that it is only one of a number of infections that pose a risk to patients.'
Derek Butler, chairman of MRSA Action UK, said the Government was relying on major reductions in infections at a few hospitals to make the overall picture look good, but this masked the fact that some hospitals were making virtually no headway or had got worse.
In the last quarter, one-third of trusts had more MRSA cases than the previous quarter while a further one-fifth had made no improvement. Seventeen hospitals had more MRSA cases last year than in 2004.
Tory health spokesman Andrew Lansley said: 'It is a disgrace that there have been more than 800 cases of MRSA in our hospitals in just three months.
'Labour have let down patients by caring more about spin than doing what it takes to root out infections. For years even the Government's own advisers have been telling them that we need to identify infected patients as early as possible and then isolate them to make sure the infection doesn't spread.
'But Labour have broken their promises on this and three-quarters of hospitals still lack proper isolation facilities.'
MRSA kills almost 2,000 hospital patients a year in the
Superbugs' grave threat
Superbugs are threatening to return the world to 'a preantibiotic era' and devastate modern medicine, experts have warned.
A global response is needed to address rising bacterial resistance caused by use and abuse of antibiotics, according to Professor Otto Cars and colleagues.
All antibiotic deployment 'uses up' some of the effectiveness of that drug and diminishes the capacity to use it in the future, they say, and antibiotics can no longer be considered a renewable source.
Writing online in the British Medical Journal, they point out that existing antibiotics are losing their effect at an alarming rate while the development of new antibiotics is declining.
More than a dozen classes of antibiotics were developed between 1930 and 1970, but only two have been developed since.
Professor Cars, of
Daily Mail
Comment
A clean start?
NHS staff were yesterday praised by Gordon Brown for a 'dramatic fall' in MRSA superbug infections. To this, the Mail adds our own congratulations.
No newspaper has been more ferocious in attacking the scandal of disgusting, filthy hospital wards, and the loss of countless lives to MRSA through a lack of simple, basic hygiene.
So it is only fair we recognise the hard work that has reduced the overall number of cases by 57 per cent, meeting a target set by Ministers back in 2004.
But a note of caution: big reductions in some trusts mask the fact that, elsewhere, infection rates are actually getting worse.
There can be no complacency, either. The New Labour years are littered with targets which - once met - were abandoned, allowing the problem to return more virulently than before. What an unforgivable, fatal mistake that would be.
Gordon Brown hails cut in MRSA Superbug infections
Rates of the hospital superbug MRSA have dropped by a thrid in a year meaning the Government target to reduce infections has been met.
By Rebecca Smith, Medical Editor
Last Updated: 6:08PM BST 18 Sep 2008
Official data shows the number of patients suffering MRSA bloodstream infections dropped by 36 per cent in the last three months compared to the same period last year.
This latest fall means the Government target to cut infection rates by half from the 2003/4 baseline has been met and exceeded by seven per cent.
Gordon Brown wrote an open letter to all NHS staff thanking them for a 'tremendous achievement' in hitting the target.
But critics warned these cases are only the most severe infections where the bug is circulating freely around the bloodstream. The NHS does not count the number of people who have isolated MRSA infections where the bug has infected a wound but not entered the bloodstream.
The latest figures from the Health Protection Agency show that there were 836 cases reported in
This is a 14 per cent decrease on the previous quarter when 969 reports were received.
In the same period in 2007 there were 1,306 reports of bloodstream infection were received.
A spokesman for the charity MRSA Action UK said they welcome the reduction but with 'trepidation' as "we fear we are not recording the true extent of the problem with this particular bacterium". He said the reduction in cases has not been uniform across the country and a 'postcode lottery' still exists.
Professor Peter Borriello, Director of the Agency's Centre for Infections, said: "The reduction of health care associated infections is a big challenge throughout the world and the falls we are seeing in cases of MRSA bloodstream infections demonstrate the huge efforts being made by NHS staff to tackle these infections."
Health Secretary Alan Johnson said: "Our strategy for tackling infection is clearly delivering results and the NHS continues to work hard to ensure hospitals are clean and safe for patients. But we are certainly not complacent and we won't stop here. Healthcare associated infections present a huge challenge to health services across the world and we will continue to do all we can to tackle them."
The bug that can kill within hours
By Paul Burnell
BBC File On 4
Harry was a fit and healthy 27-year-old, who thought he was suffering from flu-like symptoms after a foot infection but within hours his life was hanging in the balance.
As he struggled for breath doctors at the Royal Devon and
His chances of survival were rated as less than 50/50 at one stage.
PVL is a toxin which is produced by Staphylococcus Aureus bacteria (the same bug family as MRSA) and destroys white blood cells.
It can spread to the lungs causing fatal pneumonia, or lead to blood poisoning or necrotising (flesh-eating) infections.
People under 40 are especially vulnerable to this infection.
The first fatality in the
"Doctors suggested I might lose my foot, I think at that time I wasn't really aware, of how ill I was," Harry told BBC File On 4.
Fortunately Harry, unlike some who have been affected by this bug, has suffered no lasting effects.
Superbug fight
As hospitals battle with superbugs like MRSA and C-Diff, some microbiologists are concerned about the growing incidence of PVL-MRSA in the community and whether enough priority is being given to spot and prevent it.
"I am seeing a dramatic increase in ordinary PVL," said Dr Morgan, who expects this to lead to a rise in the mutant strain of MRSA.
Prompt diagnosis is essential but as she explained, "In the early stages it is easy to miss."
The Health Protection Agency is charged with co-ordinating health protection across the
Its monitoring of PVL related diseases in
Professor Brian Duerdan, the Inspector of Infection Control at the Department of Health, admits however that many aspects of this virulent bug are a mystery.
"We do know that it spreads in the community amongst close contacts, families, people who share the same sporting events.
"But we still need to know a lot more about its exact prevalence in the community," he said.
However there are microbiologists who fear too little funding is being devoted to a bug, which would be extremely difficult to control if it hit epidemic proportions.
Hugh Pennington, Emeritus Professor at the University of
"The scandal here is that we know what to do, the technology's there to spot these things as they are appearing and we know how to react to them.
"It would be quite wrong if we allow these things to develop and of course history tells us that it we do neglect these bugs, we neglect them at our peril."
Suspect PVL samples are sent to two laboratories one in Colindale and the other in
Microbiologists such as Professor Richard James, from the
Epidemic fear
Prof Duerdan however said the government strategy is not merely based on PVL testing but on enabling medical staff to diagnose it clinically.
The fear remains however that the
"I think the HPA and the government are doing a fair amount to deal with this. The problem is that this is one bug you cannot afford to be complacent with," said Dr Morgan.
"The longer the bug is ignored, the longer it has to mutate to change into some other form and to produce other toxins."
Using antibiotics for colds increases superbug resistance, says HPA
Patients should not ask their GP for antibiotics for simple coughs and colds, the Government's public health watchdog has warned, as it said that increasing resistance has created an "urgent" need for new drugs to fight superbugs.
By Kate Devlin, Medical Correspondent
10 Sep 2008
A move to over-the-counter antibiotics could make the problem worse, the Health Protection Agency warned.
Doctors are running out of medications for potentially deadly infections, the organisation said, although new drugs have been found which could help to stabilise the number of cases of MRSA.
Rising resistance levels mean that some bugs are treatable only with antibiotics previously used as a "last defence".
The number of potentially fatal E.coli blood poisoning cases which are resistant to a "last" antibiotic have tripled in the last six years, and now make up 12 per cent of all cases.
In these cases doctors are left able to use only less effective antibiotics, which can be toxic, and raises the prospect that a strain could become entirely resistant to antibiotics.
Dr David Livermore, the agency's top scientist, warned that the problem posed a major public health threat.
Patients should not request antibiotics from their GPs when they are simply suffering from a cough or a cold, for which the drugs are useless, he said.
He said: "Most common cough and colds are caused by viruses and therefore patients should not be asking their doctor for an antibiotic."
He added: "The doctor should also know that they are not necessary and the patient should know that they are not appropriate."
Last year Sir Liam Donaldson, the Chief Medical Officer for
Around 38 million antibiotic prescriptions are handed out by GPs every year, at a cost 175 million pounds.
Studies estimate that between 25 per cent and 35 per cent of those drugs were given for viruses.
Dr Livermore also said that there was a "concern" that providing an antibiotic over the counter could increase resistance.
He also called for action to increase the amount of research into new antibiotics.
Studies have shown that it costs around 1 billion pounds to bring a new style of drug to market, including the cost of unsuccessful trials.
In recent years pharmaceutical companies have found that antibiotics, which are generally taken for a short time, are not as lucrative as things like heart drugs, which can be taken for decades.
He called for a change in the rules of clinical trials so that drugs only had to prove that they were safe and effective before they could be used,.
The situation was "worsening", he warned.
Most resistance of E.coli occurred in older patients who represented complicated cases and tended to have already had repeated courses of antibiotics.
He added: "But it is becoming more resistant. Hospitals are having to use what were second-line antibiotics first."
Derek Butler, the chairman of MRSA Action UK, agreed that more antibiotics were needed.
"One problem is that at the rate at which we are using them, resistance is building up very fast.
"To make back its investment a drug needs to be used for 10 to 15 years, which means there it is not very profitable if resistance starts to build up within five."
Monday 8th September 2008
Liz Barclay interviews Professor Hugh Pennington and Derek Butler about the latest Government claims that the MRSA target has been met. A transcript of the interview is given below, with an account from a patient who describes their exprience in hospital after contracting MRSA twice.
Transcript
Liz Barclay
The Department of Health looks like it has met it's target of halving the rate of MRSA infection in
So what are we to make of all the figures? Well, before we move onto an expert panel, let's hear from someone directly affected, Leone from
Leone
I was admitted to a ward and placed in a side-room and told I was nil by mouth because I would be having the operation the following morning. I was advised I would not be able to leave the room or use any of the toilet facilities because of fear of passing on any MRSA to other patients and I understood that fully. The following morning I was seen by the doctor and he said no the operation wouldn't take place, that they would need to pack the wound, observe it for a while with the tissue viability nurse who wouldn't be available for another two days, and I would have to stay in hospital.
For me it was an awful scenario because I felt I could be at home, rather than wait in hospital. I wasn't allowed to leave this room, I had a commode brought in, I couldn't use it properly because the curtains in the room didn't actually close properly, and I was overlooked by another ward where people obviously could see into my room. Despite there being a trolley outside the actual room with gloves and alcohol gel and aprons, members of the public just kept constantly walking into the room. My drug chart wasn't actually held on the ward, it was sent down to the actual pharmacy for it to be made up. It was down there all day and as a result I wasn't given any pain relief, I wasn't actually fed because I was in this room isolated, they had actually forgotten I was there. And by the end of the twelve hours again I'd had enough so I just discharged myself and left.
Liz
What would you say has been the overall impact on your living with cancer, of the fact that you have also contracted in hospital MRSA twice?
Leone
You are already trying to cope with the fact that you've got cancer, for me it was the third time and I was beginning to think for me is this the episode where my time is up, to then have the MRSA and be treated like a leper, psychologically I was traumatised. I was in a substantial amount of pain. People just don't seem to understand your paranoid about catching other bugs, you are paranoid about how people are going to react to you when you say that you've had MRSA. I still don't sleep properly of a night-time because my actual wound, the way it healed, it was just a lump sticking in my chest that was constantly there, the pain it's indescribable. I'm scrupulous about cleanliness to the point where I'm scared of getting OCD - obsessive compulsive disorder. I don't go anywhere unless I've got hand-gel, and I use it religiously, and I insist on people coming into my house using it, because I'm so paranoid about bugs.
Liz
Leone whose been infected with MRSA. Hugh Pennington is Emeritus Professor of Bacteriology at
Derek
Our take on the latest set of statistics is quite simple, that the Health Secretary is being very economical with the truth. He has said that they are within touching distance, what the Health Secretary has forgotten is that infections have risen faster under this Government, than any Government in history. Now we've done our own analysis of the figures and we've found at least seventeen hospital trusts with higher infection rates of MRSA bacteraemias now than four years ago.
Liz
Well that's seventeen Trusts out of how many?
Derek
It's seventeen Trusts out of one hundred and seventy, but it's still ten percent. If you look at the figures again sixty-four percent of those hospital trusts across
Liz
Let's bring Doctor Sara Mumford into the discussion, she's the Director of Infection Prevention and Control at Maidstone and Tunbridge Wells NHS Trust in
Doctor Sara Mumford
I think there are problems generally with different trusts, they have different challenges and therefore they will perform differently. We all know what it is we have to do, and everybody's working very hard to achieve that but there are sometimes circumstances of outbreaks that occur which are unpredictable, which then have to be dealt with, which can actually skew the figures very greatly in a very short space of time. When you are dealing with very small numbers of cases as most Trusts are, then just one or two extra cases can skew your figures quite dramatically.
Liz
Well, Hugh Pennington is with us now, I wanted you to talk Professor Pennington about the figures which have been described by the Health Secretary as a remarkable achievement. Let's deal with rates of MRSA in hospitals in
Professor Hugh Pennington
Well, the rates are not getting any worse, and there is a trend downwards, but I think one thing must be remembered about the MRSA figures, that these are not infections, these are bloodstream infections?
Liz
The most serious ones?
Hugh
Well, yes they are, and they are preventable by for example looking after ventlons and intravenous lines and so on. A lot of attention is paid to that, and that impacts on the MRSA figures. It doesn't necessarily tell us that the MRSA itself is getting any less common, it's just an indirect measure. Leone for example, the patient we are hearing from, her infections probably wouldn't appear in the statistics at all, unless she had a bloodstream infection, it didn't sound as though she did, so she would just go under the radar, and lots and lots of patients will be going under the radar because they are not being measured. There are good reasons why bloodstream infections are a good measure of bloodstream infections because their technology is very sound and hospitals generally use the same method so they are comparable. They give a trend, they give an impression that MRSA is at least not getting any worse, I wouldn't go any further than that.
Liz
Now these figures are for
Hugh
Well, certainly in Scotland which clearly is where I work, the figures are roughly similar perhaps, we are not doing quite as well, but the trend there is not as statistically significant a trend downwards for MRSA bloodstream infections, but there is a sort of hint in them, yes they are getting better, they are certainly not getting any worse. So I think overall in Scotland and in England the figures are really quite similar, perhaps not the same decrease in Scotland to the same degree as in England, but the same generally. The problem is not getting any worse is the best thing one can say about it.
Liz
And Wales?
Hugh
Much the same.
Liz
What about C.difficile?
Hugh
Well, C.difficile is quite a different kind of problem, MRSA is something that evolved in hospitals. It's a hospital acquired infection essentially. C.difficile is quite common out there and if you have antibiotic treatment, you can get C.diff as a consequence of that, never mind hospitals, its hospital spread as well, because the C.diff problem is much bigger than the MRSA problem. It kills people more often unfortunately. And we had a very bad outbreak in Scotland when quite a number of people perished in a hospital, due to hospital spread of the organism, so C.diff is proving a very, very difficult problem to crack, and of course it doesn't fall to alcohol gels, in fact they make it worse, so all the effort that's gone into MRSA has got to be redoubled for C.diff, and also we have to look at different approaches too.
Liz
Doctor Sara Mumford, the Trust that you have now joined in the past has been notorious for hospital infections, but you've managed to cut infection rates by three quarters over a single year, how has that been done?
Doctor Sara Mumford
Well we've actually put a whole system change into action within the Trust, so everybody's become involved right from the Board right down to the ward level. We've put lots of different strategies in place. Our cleaning has increased, we are spending more than a million pounds extra every year on cleaning compared to when we had the outbreak. Everybody has a huge level of awareness, we are regularly giving all of the staff updates on infection control. We've put very strong hand hygiene protocols in place, so that everybody's cleaning their hands very, very regularly. We've got all the staff bare below the elbows. We've banned neckties for anybody who is going on the wards to work. We've just generally increased our levels of infection control. We also have isolation wards where all of the C.diff patients are nursed together by specialist nurses so that they receive a very high standard of care, they also have a multi-disciplinary team approach to the treatment of C.diff, so that we involve clinicians, microbiologists, nutritionists, tissue viability nurses, so that we can really give them a very high standard of care which is protocol driven.
Liz
Derek Butler, the Prime Minister ordered a high profile deep clean of all NHS hospitals in
Derek
In a simple answer, no. The Prime Minister has been very good with his populist figures. A good example of that would be on the 18th of September. Normally the quarterly figures come out in January, April, July and October for C.diff and MRSA infections. This year for the first time the Government has decided to bring the MRSA figures out for the April to June period on the 18th of September, conveniently two days before the Party conference, now doesn't that give you some impression of what this Government is doing with healthcare infections with the numbers and things like that for their own belief.
Liz
Hugh Pennington, there is isn't there now this gap in credibility where statistics are concerned?
Hugh
Well yes, it's always been there ever since the days of Florence Nightingale, who used statistics very, very ably as a political weapon. I think we must remember that statistics are used either to justify what you are doing or to attack the opposition or whatever it is and they all have to be looked at very, very carefully, and as I was saying the MRSA figures are only telling you a part of the story. They are not telling you about how many people are getting infections in their hip operations and that kind of thing. But at the end of the day we certainly are getting better at these figures we are getting better at collecting them and they are getting more reliable. And one of the most important things about these figures is to look at the trends of course, and I think it's a little early to say yet that we've licked the problem. We must remember that we have ten and twenty times more of these problems certainly with MRSA than countries like Holland and Norway which have had a very, very strict control on them, doing what Sara's describing in Maidstone, and doing it for many, many years. We are only starting to do that now, and the scandal really is that we weren't doing it ten and twenty years ago.
Liz
Professor Pennington, Derek Butler, Sara Mumford we leave it there and the Department of Health sent us a statement saying that they have set a target now to deliver a thirty percent reduction in C.difficile over the next three years, and they say that they will have been investing two-hundred and thirty million pounds every year to try to meet it.
 |
08/09/2008 Update Hospital Infections |
From
August 29, 2008
Big bang moment in fight against hospital superbugs
Scientists at two Scottish universities have discovered a way to make bacteria explode, a breakthrough that may lead to new methods of killing hospital superbugs such as C. difficile and MRSA.
The scientists at St Andrews and
The channels are also present in MRSA and C. difficile and the scientists believe their findings could help them develop new antibiotics to combat the drug-resistant bugs.
Professor Ian Booth, who led the team from the
"Understanding how they work will play a major role in inhibiting the survival of bacteria and could have applications as basic as cleansing hospital equipment and wards or helping to make food safer."
He added: "These channels are found in MRSA and C.difficile and this knowledge has not yet been exploited. The future path is to find new chemicals and processes that exploit the importance of the channels to these bacteria."
The discovery was hailed by Nicola Sturgeon, the Scottish Health Secretary, and Hugh Pennington, Professor of Bacteriology at the University of Aberdeen, who said that it "opened new territory" in the fight against antibiotic-resistant bugs.
C. difficile and MRSA are linked to poor hygiene and the over-use of antibiotics. Recent figures from the Scottish Audit of Surgical Mortality show that deaths from MRSA and other similar bacteria have continued to rise in
This year nine patients at Vale of Leven Hospital died as a direct result of an outbreak of C. difficile, with the bug cited as a 'contributory factor' in the deaths nine other patients.
The discovery of the channel, which is reported in the journal Science, is the culmination of molecular research at
Together, the teams were able to exploit the fact that all bacteria have tiny channels in their walls. These operate like the valve on a pressure cooker, opening and closing to release pressure in the cell.
James Naismith, Professor of Chemical Biology at
"The motion is just like that of a camera iris and being able to see this motion is an amazing discovery.
"Not only is this a major step forward in scientific understanding of a fundamental process in biology but it paves the way for the development of new drugs against bacteria.
"It is vital to the bacteria that the channel fully closes and only opens at the right times as mistakes either way would be fatal.
"New chemicals designed to force channels to stay open or shut, are likely to kill or at the very least, greatly slow down the growth of bacteria.
"Slowing down the growth gives the body's natural defences time to tackle its bacterial invader."
The two groups have been working together for several years and were supported by the Scottish Universities Life Sciences Alliance, which was launched a year ago by the Scottish Funding Council. They received a 1.5million pound grant from the Wellcome Trust and funding from the Medical Research Council, the Biotechnology and Biological Sciences Research Council and Unilever.
Professor Booth said: "This was a very demanding project and is down to tremendous team work in both universities."
http://www.timesonline.co.uk/tol/news/uk/scotland/article4636638.ece
Lib Dems challenge MRSA performance
Published: 21 August 2008 09:00 Author: Charlotte Santry
Nearly two thirds of trusts failed to hit the government's MRSA target, the Liberal Democrats have claimed.
The party compared infection rates for 2007-08 with 2003-04, to see whether the target to halve MRSA rates by March 2008 had been hit.
Their figures contradict official statistics released in July, when the government announced it was within "touching distance" of the target, calculated using quarterly averages.
The Liberal Democrats said it was fairer to compare annual figures rather than quarterly averages because the baseline was the total number of cases in 2003-04.
"No one's disputing there have been improvements but there's still a long way to go"
Liberal Democrat health adviser
Last year's public service agreement target requires that the average annual number of MRSA bacteraemias for 2008-09 to 2010-11 should be less than half the 2003-04 figure.
Missed targets
The Liberal Democrats' analysis shows 64 per cent of trusts did not meet the target and in 23 trusts MRSA rates rose.
In January, opposition parties accused the DH of moving the deadline for the target to include April to June 2008 figures.
A memo leaked to HSJ last year revealed DH fears that the target was likely to be missed. A spokesman said the target had always been recorded in the same way and needed to use April to June figures to take into account improvements made at the end of March.
Response from MRSA Action
Saturday 23 August 2008
MRSA Action UK absolutely agree with the stance taken by the Liberal Democrats, and stand by our statement made about the figures on the 15th August 2008 The target has been missed. There are big improvements in many trusts, but there has also been deterioration and not enough effort put into preventing avoidable infections in others. We know that great strides have been made in many hospitals and those staff should be applauded, but a postcode lottery remains and this should be recognised by the Department of Health. Moving the goal posts and ignoring the concerns of the public and patient representatives and stating that publicising the truth is a "breach of trust" is frankly outrageous. If there is any breach of trust this falls on the way the figures were reported when statements were made to say that the NHS were "just short of the target". Public confidence is at an all time low and this kind of massaging of figures and moving of goal posts does nothing to restore it.
From The Sunday Times
August 10, 2008
Doctors' dirty hands spread MRSA
A quarter ignore crucial
hospital hygiene guidelines, figures show
Stuart MacDonald
A quarter of hospital doctors are ignoring hand- washing guidelines designed to halt the spread of deadly superbugs such as MRSA and clostridium difficile.
New figures from Health Protection Scotland (HPS) show that the number of medics failing to observe the basic hygiene procedures has risen despite a national campaign to encourage health workers and hospital visitors to wash their hands.
While 90% of nurses and 85% of ancillary staff are meeting World Health Organisation hand hygiene standards, only 75% of doctors are doing so. This represents a 3% drop from the previous quarter and is well below the Scottish government's target of 90%.
The HPS states that "hand hygiene is the single most important factor" in reducing and preventing hospital- acquired infections.
Last week Nicola Sturgeon, the health secretary, called for a zero-tolerance approach to hand hygiene in the wake of a damning report by HPS into a clostridium difficile outbreak at the Vale of Leven hospital in Dunbartonshire.
Nine patients died as a direct result of the infection, which was linked to a further nine deaths. NHS Greater Glasgow and
There were 285 deaths linked to clostridium difficile in Scottish hospitals between December last year and May this year, almost double the rate for the whole of 2006. MRSA kills a similar number.
Professor Hugh Pennington, emeritus professor of bacteriology at