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Colchester Hospital fined after MRSA death
10:35am Tuesday 9th November 2010

A HOSPITAL trust will be penalised after a patient died in its care after contracting a deadly superbug.

Colchester Hospital University NHS Foundation Trust is to be docked tens of thousands of pounds after a woman picked up MRSA and died at Colchester General Hospital. The hospital said although the superbug may have contributed to her death, it was not the main cause.

However, primary care trust NHS North East Essex will not pay for her treatment under a Government drive to introduce financial penalties for hospital acquired infections.

It is first time the hospital has been stung by the tough new initiative.

The hospital has not released the identity of the patient who died, or revealed how much money it will be docked, but it is believed it will be at least tens of thousands of pounds.

Mark Prentice, hospital spokesman, said the trust otherwise had an 'excellent record', having reduced the number of cases of MRSA year on year, from ten between 2008 and 2009, eight cases between 2009 and 2010, to one this year.

He said: "In our contract with NHS North East Essex, both organisations have agreed the trust will not be paid for any patient in these circumstances and that is what has happened in the one case this year.

"The amount of money involved is still being finalised." Derek Butler, of MRSA Action UK, said he had concerns about hospitals being penalised for infection rates. He added: "I'm a little worried about the Government's new scheme.

"It means people could end up arguing about where the infection came from to avoid incurring extra costs. What's more important is the hospital learns from it and eliminates that problem, to prevent it happening in the future."


Superbug invader identified in New Delhi is linked to five deaths in UK hospitals
By Jenny Hope
Last updated at 7:57 AM on 28th October 2010

A deadly superbug imported from the Indian sub-continent and resistant to the most powerful antibiotics has been linked to the deaths of five patients in NHS hospitals.

They were among the toll of 64 Britons infected with the bug, most of whom were "health tourists" who had returned from surgery in India and Pakistan.

Health watchdogs have warned that patients who have been treated there should be tested for the superbug if they develop an infection that is hard to eradicate with antibiotics.

But infection experts and campaigners fear too little is being done to track NDM-1, which is short for New Delhi metallo-beta-lactamose, after the city in which it was identified.

They claim the NHS could face a rapid rise in cases without better monitoring and screening, and that cuts affecting the infection control service could exacerbate the problem.

For the first time official figures show five patients have died in NHS hospitals while infected with NDM-1.

The superbug is resistant to one of the major groups of antibiotics - the carbapenems - which remains active against bacteria that are already resistant to standard drugs.

The deaths, which will be detailed by Channel 4 News tonight, have heightened concerns that surfaced in August when a study in The Lancet medical journal reported that 50 Britons were infected.

Dr David Livermore, of the Health Protection Agency, stressed the superbug was not necessarily the direct cause of death because the patients all had serious medical conditions.

But he is worried it could get out of control. He said: "When you look at population flows, it looks likely we'll continue to import more and more of this bacteria.

"The fear has to be that they get traction within UK hospitals and they start to spread from patient to patient within the UK."

NDM-1 is an enzyme that alters bacteria, making them resistant to nearly all antibiotics. It has largely been found in E.coli bacteria so far.

However, experts are alarmed by its potential ability to transfer into superbugs already with us, like MRSA and C.diff, which would make the resulting infection even more deadly.


A survey found the bug was more widespread in India than previously thought, after the Channel 4 investigation took 100 samples from open sewers around New Delhi.

It was detected in six separate locations, many more than would have been expected.

Professor Hugh Pennington, a leading microbiologist, said its discovery at a range of sites suggested it was widespread in India, but likely to be found in other countries.

He said it was essential NHS staff remained focused on hygiene measures such as hand-washing.

Derek Butler, chairman of MRSA Action UK, said the Coalition must extend the recording of all bacteria and widen screening.

The recent decision to axe the Health Protection Agency as part of the "bonfire of the quangos" was a "clear mistake", he added.

"With the emerging threats from organisms like NDM-1, this is not the time to cut infection control budgets."

Dr Vishwa Katoch, of the Indian Council for Medical Research, said the country had been unfairly singled out.

He added: "Such superbugs are everywhere. India has a problem, but India has the same problem other countries do."

For the full report, see Channel 4 News tonight at 7pm.

Read more on the Daily Mail website



Express.co.uk - Home of the Daily and Sunday Express - Breaking news, sport and showbiz from the World's Greatest Newspaper
NEW DRUG "A LIFESAVER" IN WAR ON SUPERBUGS
Sunday September 19, 2010
By Lucy Johnston, Health Editor

BRITISH scientists have developed a drug they claim holds the key to eradicating deadly superbugs. Their breakthrough is being hailed as a potential weapon in the fight against MRSA and C-diff. Scientists hope it will save thousands of lives a year. The new anti-bacterial drug, code-named XF-73, kills superbugs within five minutes, meaning deadly bacteria have little chance of developing any resistance to it.

Last night Professor Ian Chopra, an expert on bacteria at University of Leeds, said the development was "extremely exciting". He added: "Resistance to antibiotics is seriously undermining the ability of the medical profession to treat bacterial infections.

"Society urgently requires the discovery and development of new anti-bacterial drugs that have a different method of action and minimal potential for the development of resistance. XF-73 fulfils this need. The bactericidal potency of these drugs is remarkable."

MRSA did not show any resistance to the new drug in clinical tests, even after 55 repeat exposures. Scientists believe XF-73 could be used to prevent the spread of infection on hospital wards within three years. It could be curing patients already infected with MRSA within six. During tests, carriers of superbug bacteria had XF-73 gel placed inside their noses. The bugs were completely eradicated with no side effects. Dr Bill Love, chief executive of Destiny Pharma, the Sussex pharmaceutical company behind the new product, said: "This is a major breakthrough.

"Thousands of lives could be saved by destroying bugs in patients before they become susceptible to infections through medical procedures such as operations. XF-73 works differently from antibiotics by breaking down cell walls and causing the rapid loss of its vital contents. Antibiotics act by destroying specific parts of bacteria to disable them, a process that takes much longer.

Most antibiotics have little impact on superbugs and scientists feared it was only a matter of time before they completely resisted them. One of the most recent threats has been the emergence of the gene NDM-1, which alters bacteria making them resistant to even the strongest treatments. Dr Love said: "The miraculous generation of drugs which began with penicillin may soon be overrun by multi-antibiotic-resistant superbug strains.

"We believe XF-73 holds the key to preventing the major cause of hospital bacterial infections worldwide." Destiny Pharma made its XF-73 discovery about eight years ago. But it was not until last week that the results of its clinical trials were announced at the Interscience Congress on Antimicrobial Agents and Chemotherapy in Boston, US.

Derek Butler, chairman of MRSA Action UK, welcomed the new drug. He said: "There is always the fear that bacteria will develop resistance to the only medication available to eradicate MRSA from a patient who carries the bugs.

"We are aware not everyone can be decolonised from MRSA using the present treatment available so this new development of treatment has shown great promise.

"We hope the Government will give its backing to this new development and that the National Institute for Health and Clinical Excellence will authorise the use of this new agent in the fight against bacteria such as MRSA."


Now, drug that kills deadly superbugs within 5 minutes September 19 2010
British scientists have developed a drug that may hold the key to eliminating deadly superbugs.

The new anti-bacterial drug, code-named XF-73, kills superbugs within five minutes, meaning deadly bacteria have little chance of developing any resistance to it.

"Resistance to antibiotics is seriously undermining the ability of the medical profession to treat bacterial infections," the Daily Express quoted Ian Chopra, of University of Leeds as saying.

"Society urgently requires the discovery and development of new anti-bacterial drugs that have a different method of action and minimal potential for the development of resistance. XF-73 fulfils this need. The bactericidal potency of these drugs is remarkable," he said.

MRSA did not show any resistance to the new drug in clinical tests, even after 55 repeat exposures.

Scientists believe XF-73 could be used to prevent the spread of infection on hospital wards within three years.

During tests, carriers of superbug bacteria had XF-73 gel placed inside their noses. The bugs were completely eradicated with no side effects.

Bill Love, of Destiny Pharma, the Sussex pharmaceutical company behind the new product, said: "This is a major breakthrough.

"Thousands of lives could be saved by destroying bugs in patients before they become susceptible to infections through medical procedures such as operations."

F-73 works differently from antibiotics by breaking down cell walls and causing the rapid loss of its vital contents. Antibiotics act by destroying specific parts of bacteria to disable them, a process that takes much longer.

"We believe XF-73 holds the key to preventing the major cause of hospital bacterial infections worldwide," said Love.

Although it was discovered eight years ago, the results of its clinical trials were announced last week at the Interscience Congress on Antimicrobial Agents and Chemotherapy in Boston, US.

Derek Butler, MRSA Action UK, welcomed the new drug.

He said: "There is always the fear that bacteria will develop resistance to the only medication available to eradicate MRSA from a patient who carries the bugs.

"We are aware not everyone can be decolonised from MRSA using the present treatment available so this new development of treatment has shown great promise." (ANI)

(c) 2004 sify.com India Limited. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed."


Be careful what you cut in the NHS
Monday, August 23, 2010

The National Health Service in Scotland is facing its biggest challenge in a generation, having already seen the tightest NHS financial settlement since devolution.

Scottish health boards are looking to cut spending by at least 270 million pounds this year and Audit Scotland has warned that it will be difficult for some to achieve the required level of savings without a negative impact on the services they provide. In practice, this means that across the country staffing levels are being reduced, training budgets are being squeezed and frontline services are being cut.

NHS Lothian, for example, is looking to axe 700 NHS jobs this year and a further 1,300 next. As part of the cutbacks, their lauded cancer care team will not be expanded, even though demands on the service are likely to increase with a growing and ageing population.

In NHS Greater Glasgow & Clyde, the axe will fall on over 1,250 jobs, and more than half of them will be nurses. You cannot get rid of so many frontline staff without having an impact on patient care. Also in Glasgow, the equivalent of 500 cleaning hours a week are being shed at the city's Royal Infirmary and similar cuts are planned at other hospitals across the city.

In other areas of Scotland, specialist nurses have been redeployed to ward duties, their particular expertise lost to those patients who require tailored care. Community midwifery units have been closed at night-time with an on call service operating in place of 24/7 provision. It has even been reported that some NHS managers have put a block on the supply of tea and coffee for inpatients.

The NHS must resist the pressure to make quick savings by cutting frontline services. Savings can be made in the salaries of senior managers, but we shouldn't be cutting back on cancer specialists, nurses or hospital cleaners.

Our hospitals must be cleaner and safer. At the most basic level, people go into hospital to get better, not to be infected with life threatening illnesses. As the local MSP for Dumbarton, I was proud to support the families who lost loved ones to C. difficile at the Vale of Leven in their campaign for a public inquiry. This was the worst outbreak, in terms of mortality, of C. difficile in the UK.

I am deeply concerned that the number of patients and staff infected with norovirus has almost doubled in the past year, closing numerous wards across hospitals in Scotland. The same conditions that allow norovirus to flourish also leave us exposed to more serious infections like C. difficile and MRSA.

Scottish Labour drew up a 15-point plan with assistance from leading health experts Professors Hugh Pennington and Brian Toft. We will continue to press the Scottish Government to implement it in full. But the progress we desperately need in the fight against infection cannot be achieved if hospitals are cutting back on cleaners to save money.

Despite real progress over the last decade, cancer still casts a dark shadow over Scotland and more has to be done to reduce cancers; a new right halving the time from one month to two weeks to see a cancer specialist and get results needs to be introduced as, at present, the waiting time for people referred by their GP for cancer tests is 31 days. To meet this target, 10 million pounds must be invested each year, based on Scottish Government costs of reducing current waiting times, and a cancer expert to drive progress should be appointed.

I also believe that it is unfair and unjust that Scotland is the only part of the UK where people with cancer have to pay for prescriptions. All prescriptions are free in Wales and in Northern Ireland. People with cancer in England have been eligible for free prescriptions since 1st April 2009. According to the Department of Health, up to 150,000 patients in England are benefiting, saving as much as 100 pounds a year on prescription charges.

In England, this commitment is being funded by reducing the cost of the drugs bill in the NHS by bulk buying and the use of cheaper generic products. However, cancer patients in Scotland will continue to be charged for prescriptions until 2011.

The core issue here is fairness. In Scotland, cancer not only threatens your life, but can also make you poor. I believe that the job of Health Secretary is among the most important in the Scottish Government. For too long, we have lived with the legacy of one of the most appalling health records in the Western world, but initiatives such as the smoking ban show that we are capable of turning the corner.

NHS staff and patients need to be engaged in order to defend and ensure fairness within Scottish services, and, ultimately, make our nation healthier.


Superbug fears raised over gap between testing and hospital admission
Published Date: 15 August 2010

By Lyndsay Moss

Health Correspondent

PATIENTS due to have surgery in Scotland are being screened for the deadly superbug MRSA up to three months before admission.

Documents released under Freedom of Information reveal wide variations between screening and admission to hospital, even though a lengthy gap increases the risk that a previously-uninfected patient could pick up the bug between testing and going in for treatment.

Experts said that while the risk was small, testing should take place as near to admission as possible - about a maximum of a month beforehand - to allow for anyone carrying the bacterium to be treated.

There were more than 100 cases of MRSA infection in Scottish hospitals in the first three months of this year.

Pre-admission screening was introduced by the Scottish Government to reduce the MRSA infection being carried into hospitals. The procedure involves taking a swab from inside a patient's nose to see if they are "colonised" with MRSA, meaning they carry it without actually being ill.

About 7 per cent of patients admitted to hospital are estimated to be carriers.

The antibiotic-resistant bug is most serious when it enters the bloodstream, which is a greater risk for people who are ill or having surgery.

Some NHS boards, including Ayrshire and Arran, said screening took place up to a month before admission, while NHS Grampian said most patients were screened when they arrived on wards. But NHS Lanarkshire said the longest gap was 12 weeks. NHS Highland and Dumfries and Galloway said the maximum time was nine weeks, while NHS Greater Glasgow and Clyde said screening generally took place no more than eight weeks before admission.

Aberdeen-based microbiologist Professor Hugh Pennington said: "The longer the interval between screening and admission to hospital, the greater the possibility that someone might pick the organism up. Although it's quite a low possibility, it's still there and the longer you leave it, the greater the chance.

Margaret Watt, chair of the Scotland Patients Association, became concerned after a relative was screened seven weeks before their procedure. "They (hospital officials] were quite complacent and said there's no chance of her getting it before she goes in," she said. "But how do they know?”

Derek Butler, chairman of charity MRSA Action UK, said: "We would argue that it should be done when you go in for your operation because you can get a result within hours."

Butler said there needed to be a uniform policy on screening. "We believe two weeks is the maximum it should be done," he said.

Health secretary Nicola Sturgeon said pre-admission screening for MRSA was one of a range of initiatives helping to reduce infection rates in hospitals.

Last week, it emerged that a new superbug, resistant to almost all antibiotics, had been discovered in 37 patients in the UK, including one case in Scotland.

Scientists writing in the Lancet warned of the emergence of a new gene, NDM-1 (New Delhi metallo--lactamase), which had allowed bacteria to become highly resistant to treatment.

NDM-1 spread in India, Pakistan and Bangladesh, but it was also found in patients from the UK, who travelled to India or Pakistan for medical procedures, including cosmetic surgery.


Invasion of the superbugs:
As we run out of weapons to fight them, what you can do to protect yourself
By Jo Waters
Last updated at 10:41 AM on 17th August 2010

A killer bug spreading across the globe like wildfire sounds like something out of a bad sci- fi film. But while this is still the stuff of fantasy, microbiologists are concerned about the news of an enzyme with the potential to convert all bacteria into superbugs resistant to treatment.

New Delhi Metallo-1 (NDM-1) is already widespread in India and Pakistan, according to the Lancet Infectious Disease journal. There have also apparently been 50 cases in Britain.

Worryingly, NDM-1 appears to destroy a major group of antibiotics, the carbapenems - one of the last still to work against other bacteria now resistant to other treatments.

Protect yourself: Superbugs are becoming increasingly resistant to antibiotics.

But this enzyme is by no means the only threat worrying UK microbiologists. There are at least five superbugs that have been showing signs of antibiotic resistance - and there are no new antibiotics in the pipeline.

So can we stay ahead of these superbugs? We talked to leading experts to discover what they think needs to be done - and what we can do to protect ourselves.

WHAT IS A SUPERBUG? These are bacteria that have become resistant to the antibiotics - perhaps the best known is MRSA, Methicillin-resistant Staphylococcus aureus, which no longer responds to the antibiotic methicillin. But how do they become resistant?

Bacteria are extremely adaptable and are able to mutate. What happens when they're exposed to antibiotics is that only the susceptible bacteria die - the bacteria that are already resistant to the antibiotics live.

Those surviving bacteria then multiply, spreading their antibiotic resistance to the next generation.

These superbugs kill by entering the bloodstream or the fluid in the brain and spinal cord. Once there, they release toxins which stimulate the body's immune system, causing widespread inflammation which can lead to organ failure and death.

IS THE NEW BUG THE ONLY WORRY?

In fact, there are several superbug threats microbiologists are concerned about.

KLEBSIELLA:

This infection can cause pneumonia that can kill within 72 hours. It is commonly found in wound infections and burns, and leads to lung or urinary tract infections. It's mainly a problem for patients who are already severely ill, such as those in intensive care units - there were more than 4,000 cases of it in England and Wales in 2008.

The real concern is if Klebsiella becomes a superbug - this happens when it produces enzymes called extended spectrum beta-lactamases, which destroy antibiotics. Although 11 per cent of cases of Klebsiella have shown antibiotic resistance, until now powerful antibiotics, carbapenems, have killed these strains.

The problem is that the new NDM-1 enzyme makes Klebsiella resistant even to carbapenems - making Klebsiella pneumomia completely untreatable in some cases.

PSEUDOMONAS:

This is found in soil, and can attack and kill those with compromised immune systems. Burns patients, diabetics and cystic fibrosis patients, 80 per cent of whom have lungs colonised by it, are particularly susceptible.

The number affected by pseudomonas rose by 26 per cent between 2004 and 2008, to 4,000 cases - it's one of the most common healthcare infections and is increasingly resistant to antibiotics.

E.COLI:

There is also a hard-to-treat version of this intestine bug, which causes urinary tract infections. This superbug produces an enzyme which destroys antibiotics.

E.coli bacteria have also been shown to be able to pick up resistance from NDM-1.

MRSA:

Experts also fear that a new 'Super MRSA' could mutate - a combination of the hospital-acquired version with a different form of MRSA that's developed outside hospitals, known as 'community MRSA'.

Community MRSA causes a form of pneumonia that eats away the lung tissue.

'This combination is a serious prospect because community MRSA is now becoming increasingly resistant to antibiotics,' explains Professor Mark Enright, formerly of Imperial College, London, and an expert on MRSA.

'There is evidence it's becoming more aggressive and in the U.S. it's now a much bigger problem than hospital-acquired MRSA, with the death rate rising. .

GONORRHOEA:

The sexually-transmitted disease has also developed an antibiotic-resistant form. The number of cases resistant to the antibiotic for gonorrhoea, ciprofloxacin, rose from 2 per cent in 2002 to 30 per cent this year.

Experts say resistance is endemic in England and Wales. Dr David Livermore, director of the Health Protection Agency's antibiotic resistance monitoring unit, says that although gonorrhoea still responds to other types of antibiotic, it is becoming less sensitive every year.

He says: 'There is a fear that in a few years antibiotics may not work against gonorrhoea any more.'

CAN WE CUT BACK ON USUAL ANTIBIOTICS?

Since the Thirties, antibiotics have had a miraculous impact on human mortality - but the price is antibiotic resistance.

A recent European Academy of Science Advisory Council report concluded that if current antibiotic use continues, deaths from previously treatable infections will increase. So it makes sense to cut back on the use of the drugs currently available, to try to slow down the rate of antibiotic resistance.

Britain is not the worst offender for antibiotic overuse and resistance. Dr Livermore is one of the experts calling for 'smarter' use of antibiotics to counter superbugs.

'There are particular concerns about antibiotic use in India and Pakistan, because they can be bought over the counter and the patent laws are not so strong, so there are many brands of the same antibiotic on the market.

'There is also an increased likelihood of using a weaker antibiotic. In the UK, we should be aiming to reduce use of antibiotics and prescribe the best drugs that will work for the individual patient - rather than swapping them between different types.'

The Department of Health says there has been a reduction in antibiotic prescriptions between 2007 and 2009 after education drives.

CAN'T WE DEVELOP NEW ANTIBIOTICS?

Research to find new antibiotic treatments seems to be of critical importance, but, as Professor Enright explains, the big pharmaceutical companies are just not investing in the research.

WHAT YOU CAN DO TO PROECT YOURSELF

So what steps can you take to minimise the risk?

- Use an antibacterial body wash/shampoo such as Hibiscrub before, during and after a hospital stay.

- If you're fitted with a catheter, ask for it to be removed as soon as clinically possible, says Professor Mervyn Bibb, a molecular microbiologist at the John Innes Institute, Norwich. "It is a potential source of infection."

- Ask hospital staff and visitors to use antiseptic hand gel.

- Take your antibiotics as prescribed: If you don't finish the course or take them at reduced dose there is a risk you won't kill all the bacteria, says Professor Bibb. "Finishing the course will ensure all pathogens are killed. Taking less than the prescribed amount could lead to incrementally resistant strains developing."

- Watch for signs of redness, swelling and pain around wounds and report it to medical staff.

- At home, practise good hand hygiene. Wash your hands after going to the loo and before preparing food. Regularly clean door handles, light switches and flushes on loos. Avoid sharing towels. Be vigilant about food hygiene: E. Coli can colonise meat products, such as burgers, so make sure you cook them thoroughly and they are not left bloody.

'Most drug companies have little interest in developing new antibiotics because they are not as profitable as other drugs,' he says. 'Antibiotics are only taken for a few days, unlike drugs for high blood pressure, pain or cholesterol - which are taken for long periods, providing a higher return to pharmaceutical companies,' he adds.

'I'm not confident that we're staying ahead of the bugs. We've no evidence that we'll ever get rid of MRSA and there are no new drugs being developed to tackle it and other species.'

His concerns are shared by Professor Mervyn Bibb, a molecular microbiologist at the John Innes Institute, Norwich.

'The logical extension of the emergence of NDM-1 is that pathogens will become resistant to all antibiotics,' he warns. 'It's a real problem. It's not as if we can instantly come up with something to treat this.

'We are going to need much more collaboration and investment from the drug industry if we're going to stay ahead. Maybe not enough people have died - or maybe not enough important people have died.'

However, a spokesman for the Association of the British Pharmaceutical Industry claimed the industry was committed to fighting superbugs.

She said: 'This is an issue that requires coordinated action from different stakeholders.

'There are medicines being worked on, but it's hard to get enough patients for clinical trials.'

She added it's difficult to ensure the investment required is then earned back from sales, because of the very small markets.

WHY DON'T WE SCREEN PATIENTS?

Screening patients for MRSA before they go into UK hospitals is believed to have helped reduce hospital-acquired MRSA rates in the past three years.

Dr Livermore has suggested patients could be asked whether they have had treatment in India or Pakistan, then tested for NDM-1.

However, Chris Jones, Professor of Molecular Genetics at Birmingham University, is concerned that screening for NDM-1 might not be practical, given the size of the population who have contact with India.

Furthermore, the Lancet study said most of the patients infected with NDM-1 had not had medical treatment, and had therefore acquired NDM-1 in the community.

WHAT SHOULD THE GOVERNMENT DO?

Experts are concerned that the Health Protection Agency is not doing enough 'fingerprinting' - this is where scientists keep tabs on samples of bacteria to monitor how it is mutating and developing.

The technique helped identify NDM-1. But there is a danger certain bacteria could be evolving under the radar, says Professor Hugh Pennington, of the University of Aberdeen and president of the patient group MRSA Action UK.

'We may be lucky with NDM-1 in that the Agency have identified it in time in the UK before it becomes firmly established in hospitals.

'This case illustrates how surveillance to monitor how bacteria are changing and evolving can pay off. 'But my concern is that the Agency is not doing enough of this type of work - I suspect a lack of resources prevents it.'

JUST HOW WORRIED SHOULD I BE?

Experts stress there is no need to panic, as the number of cases is small. However, the prospect of some infections becoming untreatable by antibiotics is now becoming very real.

'Superbugs that we can't just cure are not fiction any more. This will increasingly become the reality, ' warns Professor Enright.

'You would have to be very sick or unlucky to pick up an untreatable bug - but if they become more common, we will have a major problem on our hands. We have to invest in developing new treatments.'


MRSA Activists Unite Globally on World MRSA Day - Oct. 1, 2010
CHICAGO, Aug. 17 PRNewswire-USNewswire

MRSA Survivors Network, the Chicago-based nonprofit organization, launches their second annual World MRSA Day kick-off event at Loyola University Chicago on October 1, 2010. The 2010 global theme for World MRSA Day is: 'The MRSA Epidemic - A Call to Action.' Other events are planned in the United States, U.K. and Canada throughout the month of October, World MRSA Awareness Month.

"We have a fantastic event planned this year with organizations, students, health officials, infectious disease specialists, legislators and MRSA survivors and family members along with the community coming together from across the country to raise awareness for MRSA," states Jeanine Thomas, founder of World MRSA Day and MRSA Survivors Network. The October 1, 2010 kick-off event starts with a Press Conference at 10:00 a.m., followed by the Remembrance Ceremony, main event and Awards Ceremony at 10:30 a.m. The event is open to the public.

MRSA screening will be available at the event and this is the first time anywhere that MRSA screening (testing) has taken place worldwide as a part of World MRSA Day. The new World MRSA Day Web site, designed by the Maclyn Group can be found at www.worldmrsaday.org and downloadable posters are available.

2010 sponsors are: StaphAseptic, 3M, Roche, Loyola University Chicago, Loyola Medical Center, media sponsor: NBC5 Chicago. Rob Stafford, anchor for the NBC5 Chicago nightly news and contributing correspondent for NBC Dateline is the emcee.

Dr. William R. Jarvis is the Keynote Speaker for the event and also recipient of the first 'Barry M. Farr Lifetime Achievement Award.' Dr. Jarvis is president of Jason and Jarvis Associates LLC and was with the Centers for Disease Control and Prevention (CDC) for twenty three years. Dr. Barry M. Farr, Emeritus of University of Virginia was one of the first infectious disease specialists to call attention to MRSA in the early 1980's and screened for MRSA at his university hospital (UVA) and controlled MRSA. The Lifetime Achievement Award is named in his honor.

Derek Butler, chairman of MRSA Action UK is honored with the 'Man of the Year Award' and Christine Cahill, RN is the recipient of the 'Woman of the Year Award.' U.S. Senator Dick Durbin of Illinois will receive a 'Public Service Award' along with Illinois Governor Pat Quinn.

MRSA activists call for world unity from governments, health officials and organizations to take immediate action by declaring MRSA an ongoing epidemic, and appropriate funds for educational, awareness, and prevention programs to the public and healthcare industry.

The 2008 Seattle Times investigative series - 'Culture of Resistance' and the recent Las Vegas Sun's - 'Do No Harm' series illustrate the unrecognized magnitude of this epidemic - far greater than H1N1 influenza. The failed leadership in action and systematic failure to take action has cost countless lives and needless pain and suffering, with more Americans dying every year from invasive MRSA infections than from HIV/AIDS, Parkinson's Disease or H1N1 influenza.

Co-chairs of the annual event are Illinois State Representative Patti Bellock, Pat Merryweather - Senior Vice President of Illinois Hospital Association and Jeanine Thomas of MRSA Survivors Network.

Jeanine Thomas of MRSA Survivors Network is a survivor of MRSA, sepsis and C. difficile and became critically ill and nearly died after ankle surgery. She was the first patient/consumer advocate in the United States to raise the alarm about MRSA and healthcare-acquired infections and launched World MRSA Day in 2009.

For information on World MRSA Day sponsorships, participation, to donate or volunteer contact: Jeanine Thomas, jthomas@mrsasurvivors.org, 630 325-4354 USA, www.worldmrsaday.org, www.mrsasurvivors.org.


telegraph.co.uk

Should the rapid spread in Britain of NDM-1, an antibiotic-resistant enzyme dubbed the 'new MRSA', be a cause for alarm, asks Hugh Pennington
By Hugh Pennington
Published: 7:19PM BST 11 Aug 2010

Carbapenems are very useful antibiotics. Distantly related to penicillin, they can be used to treat a much broader range of bacteria, many of which are difficult to attack because they are naturally resistant to most other antibiotics.

An important group of such microbes is the Enterobacteriaceae, so called because they live mostly in the intestine. Most of the time in healthy people they cause no harm. But members of the group - particularly Escherichia coli and Klebsiella pneumoniae - are important causes of infections contracted by the sick in hospital. So a recent sudden and significant rise in the number of carbapenem-resistant bacteria in this group in Britain set alarm bells ringing.

In January last year, it caused the Health Protection Agency to issue a National Resistance Alert. The focus was on a type of enzyme, carbapenemase, that destroys the antibiotic and makes the bacteria resistant. The Antibiotic Resistance Monitoring and Reference Laboratory in London had seen only eight bacterial samples producing such an enzyme in the years up to 2007. But there were 21 in 2008 and more than 40 in 2009.

The rise in the number of cases infected with these resistant bacteria was not the only development. It was not due to a single kind of bacterium carrying a single type of enzyme - resistance in different species of bacteria was appearing, due to different enzymes. And they were being imported into the UK as on-going infections in people who had been patients in hospitals in Greece, Turkey and Israel.

The most recent development, and the one that has hit the news this week, is that resistant bacteria producing a brand new carbapenemase, NDM-1, have been found in Britain and that some of them have come here from the Indian subcontinent. Some of the implications of the discovery are truly alarming.

The story started in 2008 with a 59-year-old man who had lived in Sweden for many years but was originally from India. He returned to that country many times and was admitted to hospitals there; most recently in New Delhi, in December 2007.

He had diabetes and had developed an abscess. He returned to Sweden in January 2008 and had various tests. Small numbers of Klebsiella pneumoniae bacteria were found in his urine. The bacteria were not causing any problems for the patient - he did not have a bladder or kidney infection - but were of interest and were followed up because they were carbapenem-resistant.

The big surprise was that they were negative for all the known relevant carbapenemase genes. DNA sequencing identified a novel enzyme. Its discoverers called it NDM-1, New Delhi Metallo beta-lactamase.

A paper describing this new enzyme was published last September. It is full of technical molecular detail, but it uses plain English to say things that send shivers down the spine. The Klebsiella carrying the new gene was fingerprinted to find its type. It was ST14, a type almost identical to ST 15, which is branded as being the "new MRSA" due to its wide international distribution and carriage of other antibiotic resistance markers. So the Klebsiella was already particularly good at spreading and travelling long distances.

Just as unsettling was the finding in stools from the patient of a strain of Escherichia coli that was also carrying the NDM-1 gene. It was on a plasmid, a small DNA structure that can transfer quite easily from bacterium to bacterium. It is very likely that it had jumped from the Klebsiella to the Escherichia while they were living quietly in the patient's bowels (vice versa is possible, but the practical consequences would be no different).

The original Klebsiella plasmid carried other antibiotic resistance genes as well. No surprise there; they often do. So more bad news. The paper doesn't mince its words: "The rapid dissemination of this plasmid throughout clinical bacteria would be a nightmare scenario."

Bacteria don't need sex to reproduce, but they indulge nevertheless. They can conjugate, when a physical junction is set up to transfer the DNA, or the DNA can piggyback on a virus, or the DNA can transfer on its own. Cross-breeding between species is common. Promiscuity is the order of the day. So it would be no surprise to find the NDM-1 gene getting about, as it did in the Swedish patient. This week's news about British patients shows that it is happening.

It is clear that the NDM-1 gene had spread to different bacterial types. NDM-1 production is getting commoner; it is now the commonest kind of carbapenemase being detected in Britain. The only good news - and it hardly qualifies as that - is that there hasn't been much spread in hospitals, yet.

Seventeen of the 37 patients had a history of travel to India or Pakistan, and 14 had been in hospital in those countries. Some had had plastic surgery, others had received treatment for cancer and other serious conditions. It is also clear that NDM-1-producing bacteria are widespread through the Indian subcontinent.

What can be done? The most important action we can take right now is to make sure that hospital control procedures in Britain are as good as they can be. Stopping the spread of NDM-1 producers from patient to patient is a no-brainer. Keeping the numbers of the bacteria down will also reduce the likelihood of the spread of the gene to other organisms. Handwashing is still paramount as a way of interrupting transmission. Physically isolating patients is crucial.

Health "tourism" is here to stay. But, just as knowing where someone has been is vital in diagnosing a fever, the question also has to be asked of patients who have been in hospital abroad. It has been standard practice for years in Scandinavian countries and the Netherlands for the assumption to be made that patients who have been in hospital in Britain are MRSA-positive until screening test results have come back.

The nightmare scenario is that NDM-1 producers are close to becoming true superbugs that are resistant to everything. The horror model is XDR-TB - extensively drug-resistant tuberculosis, which broke out in South Africa in 2006, and is a significant problem in Russia, among other regions. It is reasonable to say that such strains, which for all practical purpose are so hard to treat that sufferers from them might as well be living in the 1930s, have evolved because of poorly controlled anti-TB drug prescribing. The same is true for the prescription of antibiotics in the Indian subcontinent. But it is hard to see changes coming there any time soon. Even in the UK we could do better. And hoping for new antibiotics remains just that.

There is nothing new about the importation of new bugs. Don't blame modern globalisation. Syphilis, cholera and plague were ancient imports, and they have been followed in our time by Sars, HIV and influenza. All I can say as a microbiologist is that, whatever the economic climate, my business will continue to flourish.

Hugh Pennington is emeritus professor of bacteriology at the University of Aberdeen


MRSA toll on mental health patients
3:21pm Friday 6th August 2010

THE NUMBER of mental health trust patients in North Essex infected with deadly superbug MRSA has nearly doubled in a year.

Figures released by North Essex Partnership NHS Foundation Trust show the number of MRSA cases rose by 90 per cent in the last 12 months.

Between March 2008 and April 2009 the trust recorded 20 cases of MRSA.

This increased to 38 between April 2009 and March this year.

Derek Butler of campaign group MRSA Action UK, said: "I'm disappointed there has been that big a rise.

"The focus regarding MRSA and health infections has always been on acute trusts but as a charity we have always said that we should be looking at the whole health economy.

"Patients can cut themselves or scratch themselves in that environment.

"There is bacteria and if staff are not following infection control procedures, patients will contract infections."

The statistics, published in a report into the quality of the trust's services, also showed a rise in the number of violent incidents against staff or property from about 700 last year to nearly 1000 between 2009 and 2010.

An extra 35 patients had to be sedated and there were 35 more unexpected deaths - a rise of 21 on last year.

The number of drug errors also increased from 71 between 2008 and 2009 to nearly 90 between 2009 to 2010.

However the number of serious incidents reduced from 73 to 70 this year while patient falls decreased from more than 1000 last year to 800 this year.

The trust received 400 complaints and 173 compliments in 2009 to 2010 compared to 81 complaints and 222 compliments the previous year.

(c) Copyright 2001-2010 Newsquest Media Group

Edwina Currie points the finger at the North West for failing on C.Diff
Published by GovToday for GovToday in Health
Friday 18th June 2010 - 3:45pm


Edwina Currie condemns North West Hospitals

Edwina Currie the former Minister for Health and patron of MRSA Action UK has accused North West Hospitals of failing on C.Diff standards. Speaking at a recent Manchester Based GovToday Reducing HCAI's Conference in London, Currie addressed delegates to discuss the implications MRSA has had on members of the Public. Speaking passionately about a number of cases in which deaths had occurred from MRSA, Currie pointed to recent regional figures which showed clearly that the North West is failing on reducing C.Diff.

Addressing delegates Currie said;

You can clearly see that the North West is failing to reduce the number of cases. The figures are so stark, and must worry people from the North West. Why is it the North West is still twice as high as the North East when the Government is saying that all regions, including the North West, have reduced the number of cases of C.Diff in the past twelve months?"

In a passionate speech, the former Minister talked about the victims of C.Diff and how she felt they had been let down by Hospitals who "should ensure patients are treated with the highest standards and not faced with the fear of contracting such a deadly infection".

Referring to the North West again, Currie went on to condemn the overuse of antibiotics in hospitals and communities across the region, saying;

"Is antibiotic usage too wide spread in the north west? I would put money on it! Let me guess that cleanliness is also a problem in one or two hospitals in the North West"

A number of delegates left the Conference in anger at Currie's comments with one delegate suggesting that Currie was "simply here to cause some controversy and raise the profile of her charity."

However, Currie, known for her controversy, later commented on her speech saying. "The figures clearly demonstrated that the North West is failing on MRSA and C.diff, you must remember this is my region. I am not here to cause controversy, but one thing is apparent and that is the Boards within North West Hospitals are clearly not listening or acting fast enough to reduce the number of cases."


Wipe out the superbugs, Health Secretary Andrew Lansley orders hospitals By Jason Groves
Last updated at 11:16 PM on 8th June 2010

Hospitals are to be ordered to adopt a zero-tolerance approach to tackling superbugs in attempt to slash the thousands of unnecessary deaths caused by the infections.

In his first speech as Health Secretary, Andrew Lansley yesterday said that all hospitals should move towards eradication of preventable deaths resulting from MRSA, C.diff and other superbugs.

One possibility is that all patients could be routinely tested for MRSA when they arrive for treatment.

Mr Lansley also confirmed plans to impose financial penalties on trusts that readmit patients sent home too soon.

Under Labour, emergency readmissions increased by 50 per cent, but critics fear Mr Lansley's move could backfire, with hospitals keeping patients in for longer than necessary simply to avoid the risk of a penalty.

In a speech in East London, the Health Secretary strongly criticised the former government for its seemingly endless string of superbug targets.

'I have spent too long with too many people who have lost loved ones to healthcare associated infections not to be determined to act on this,' he said.

'There is no tolerable level of preventable infections. The only acceptable strategy is a zero-tolerance strategy.'

Mr Lansley singled out the Royal Berkshire Hospital and the South-East Coast NHS, both of which have committed themselves to a zero-tolerance approach.

'If they can do it, so can others,' he said.

Both organisations are introducing MRSA testing for emergency admissions as well as routine admissions.

But the Department for Health was unable to say last night whether the scheme would be extended nationwide.

Around 3 per cent of people carry MRSA on their body without ill effects. Simple swab tests can pick up the infection, which can then be treated.

The Government has already ordered the weekly publication of MRSA and C.diff infection rates for every hospital in the country.

Officials are now looking at extending the scope of the data to include individual departments or even wards, and other bugs.

Hospital deaths from superbugs soared under Labour despite a string of initiatives to being infection rates down.

In 2008 C.diff was mentioned as a contributory factor in 5,931 deaths, while MRSA was associated with 1,230 deaths.

Derek Butler, of campaign group MRSA Action UK, last night welcomed Mr Lansley's comments, but said more detail was needed on how the policy would work.

He also warned that action to tackle superbugs would have to be extended beyond hospitals to GP surgeries and home care.

Mr Lansley also used yesterday's speech to confirm plans to tackle emergency hospital readmissions.

Under a scheme to be introduced next year, hospitals will not receive funding for the emergency treatment of patients who have been discharged in the previous 30 days.

The move is designed to end the scandal of 1,500 NHS patients a day being returned to hospital after apparently being discharged too soon. Mr Lansley said Labour's waiting time targets put pressure on hospitals to discharge patients too soon to free up beds.

He indicated that hospitals would receive additional funding for ensuring patients received appropriate treatment in the community following discharge.

But critics warned the move might result in 'unforeseen consequences'.

Dr Hamish Meldrum, of the British Medical Association, said: 'One risk is that we get a situation where decisions about discharge are based not on a judgment about what is best for the patient, but on an attempt to avoid additional costs.

'This could result in patients being kept in hospital longer than necessary.'

The King's Fund think-tank said the scheme would work only if sufficient care in the community was made available.

TRAGIC MOTHER WAS SENT HOME

A mother readmitted to hospital only five days after being discharged died after receiving 'conservative' treatment for a life-threatening illness, an inquest heard.

Donna Maben, 33, was discharged three days after being admitted with a blockage in her bowel which was causing severe sickness and diarrhoea.

When the symptoms failed to improve, she had to be readmitted.

The inquest at Ashford, Kent, heard that doctors then 'missed opportunities' and it was only when she collapsed that she had surgery - two weeks after first being admitted. She died five days later from blood poisoning.

In a narrative verdict, Coroner Rachel Redman said there had been 'an overreliance on a conservative approach' to treatment.


Patients' weekly watch on worst MRSA hospitals
By GRAEME WILSON
Thursday, June 3,2010

WEEKLY rates of superbug cases were revealed to the public for the first time yesterday - exposing huge differences between hospitals.

Ministers unveiled the statistics on MRSA and C difficile as part of a move to share more information with patients. They revealed that over the past 12 weeks there were 2,645 new cases of C diff and 183 of MRSA.

Arrowe Park Hosital in Birkenhead Merseyside, reported 53 C diff cases, the highest in the country, including ten in one week. The University Hospital of North Staffordshire had the second highest total with 44. A patient died there this year after an outbreak of new superbug ESBL.

But yesterday's figures show the C diff figures were much lower at other big hospitals. There were only 11 cases at St George's Hospital in South London and 26 at St James's University Hospital in Leeds.

Health Secretary Andrew Lansley said of the figures: "They will enable people to make meaningful choices. We want the large amounts of data already collected in the NHS to work for patients, not just managers." He said all "useful and relevant" information should be published.

Patients' Association director Katherine Murphy welcomed the weekly figures - and said the next step was figures for wards. But she added; "We have a long way to go as there are many infections not included in these figures. "We still have infection rates much higher than the best performer in Europe and the world."

Hidden

Derek Butler, of Kirkham, Lancs, set up MRSA Action UK after losing three relatives to the bug. He said: "Crucially, the figures will be from local hospitals, instead of trusts, which makes the information much more use to patients."

Helen Bronstein's mother Joyce Morrison, 83, died from MRSA in July 2008 at the Princess Alexandra Hospital in Harlow, Essex. Helen, 54, of Edmonton, North London, warned: "The real number of infections could get hidden by medics and managers who want to protect the reputation of their hospital."

Hurt by bug...


victim Joyce and campaigner Derek

g.wilson@the-sun.co.uk


Government to publish weekly infection figures for all English hospitals in transparency drive
By Sophie Borland
Last updated at 9:13 PM on 2nd June 2010

Superbug infection rates are to be published online weekly rather than monthly in an effort to shame hospitals failing to keep patients safe.

Figures for MRSA and C.difficile cases in individual hospitals were made available for the first time today, replacing tables showing the rates for NHS Trusts.

Health Secretary Andrew Lansley said the move would improve transparency and accountability in all hospital wards.

Campaigners say 'naming and shaming' poor performers is the best way of beating the bugs.

The figures reveal that the worst performing hospital for C.diff rates was Arrowe Park Hospital, in Birkenhead in Cheshire, with an average of 4.4 cases a week.

This was followed by University Hospital of North Staffordshire with an average of 3.7 cases and Nottingham City Hospital with 3.1.

The worst in terms of MRSA bloodstream infection rates were Leicester Royal Infirmary, St Helier Hospital in Carshalton, Surrey, and St James University Hospital in Leeds.

They all had an average of 0.33 cases a week. Derek Butler, chairman of MRSA Action, said that although MRSA and C.diff infections are at their lowest level since records began, fears remain that some areas are not getting to grips with the problem.

'We believe this is a significant step in the right direction and that improving the reporting from Trust level to hospital level will give patients better information on healthcare-associated infections and help them to make a better and more informed choice when planning for surgery,' he said.

The figures are currently available for each week back to March 14, and patients will always be able to look at data for the previous three months.

Infection rates for bugs such as E.coli will be added over time, and the Government has said it will look at whether figures should be provided at a department or ward level.

Mr Lansley said: 'All information that is useful and relevant to patients should be published in an accessible and open way.'

The figures are available on the data.gov.uk website.


Boots WebMD Partners in Health
MRSA & C. Diff superbug data to be published weekly
Government promises weekly hospital infection figures for 822 hospitals in England from July.

By Tim Locke
WebMD Health News
Reviewed by Dr Sheena Meredith
2nd June 2010

The Department of Health will be publishing weekly hospital data on MRSA and C. Difficile infections from July for every hospital in England. Previously figures were only made available monthly and by hospital trust, which can cover several hospitals.

In the latest figures, the Health Protection Agency says that over the previous 12 weeks there have been a total of 183 MRSA cases - 179 in acute wards. However, in the past week there have been no cases reported - but that could be due to a time lag in collecting data.

For C.Diff over the 12 week period there are a total of 2,645 cases - 97% in acute wards. In the past week there were 75 cases, again possibly because of the time lag in the statistics.

MRSA deaths The number of death certificates mentioning MRSA had been rising steadily since the early nineties, but action to better clean hospitals started to reverse the trend to 1,593 deaths in England and Wales in 2007.

This decreased further to 1,230 in 2008, a fall of 23%. The Office for National Statistics says most of the deaths were in older age groups.

Informed choices The government hopes the data will "provide vital information to help them [patients]make informed choices about their healthcare".. Though, as many of the infections are in acute wards, patients may not be able to make a choice over emergency care.

Ministers believe the extra transparency will show how well hospital managers are doing in tackling infections and will hold them to account over performance.

Health Secretary Andrew Lansley says in a news release: "This is an important step towards our broader plans to provide more relevant information to patients.

"It will enable people to make meaningful choices because they will be able to make comparisons between different hospitals and healthcare organisations.

"We want to make the large amounts of data that are already collected and used internally in the NHS work for patients, not just managers. All information that is useful and relevant to patients should be published in an accessible and open way."

More bugs to follow Lansley is also looking at providing figures for each ward or department, as long as patient confidentiality is safeguarded. He also signalled plans to add other healthcare associated infections, like E. coli and MSSA to the list.

The Department of Health will also check whether hospitals are collecting any data that is not needed, to help cut bureaucracy.

Data welcomed The decision to publish the detailed figures has been welcomed by the campaign group MRSA Action UK. Chairman Derek Butler told us that publishing the figures is "Better for patients and the public."

The transparency he says, "makes hospital staff more aware of what's going on and they can learn from each other."

"I'd like to see the figures go further, down to ward level," he says, "and ultimately publication of each surgeon's infection rates."

View Article Sources Sources (c) 2010 WebMD, LLC. All rights reserved.


Government fails to consult charity on rule change sparked by religious minority Governance | Niki May Young | 13 Apr 2010

MRSA Action UK chairman Derek Butler has questioned the Department of Health after it changed hospital clothing regulations to pacify religious objectors.

The decision, he said, was taken without any prior consultation with the charity and poses a danger to the "zero tolerance" policy for preventing MRSA and other transmittable infections.

A panel was convened by the Department of Health to re-examine its Uniforms and Workwear guidance after one Muslim nurse resigned due to the 'bare below the elbows' dress policy and the department became aware the policy "presented difficulties for a minority of Muslim female healthcare workers and students".

Butler is an advocate of 'bare below the elbows', which forbids medical professionals to wear any jewellery, watches or long sleeves, and was consulted prior to its implementation in 2007.

But the Department of Health, working with the Muslim Spiritual Care Provision in the NHS, a resource for "recruiting, training and empowering Muslim chaplains in the health service", carried out an "equality impact assessment" and changed the guidance to allow long sleeves if plastic gloves were worn on top.

This is a change which Butler believes is not easily implemented.

"We know that wearing gloves doesn't work. People don't change gloves, we've already seen this," he said.

Butler told Civil Society he doesn't know why he was left out of the discussions and that despite having a meeting with the national director of the HCAI and Cleanliness Division at the Department of Health, Janice Stevens, a week before the changes were released, he was not informed. "I can't imagine that she wouldn't have known about it," Butler added.

Both Janice Stevens and the Department of Health have ignored requests by Civil Society for information about the meeting and the impact assessment.

http://www.civilsociety.co.uk/governance/news/content/6434/MRSA_Action_UK_questions_lack_of_charity_consultation

13th April 2010

talkSPORT The Late Show with Ian Collins

Derek Butler, Chair of MRSA Action UK, talks to Ian Collins on the relaxation of the bare below the elbows dress code for Muslim staff in NHS Hospitals

13th April 2010

BBC Somerset Breakfast - Campaign for death certificate reform

Sue Willis and Derek Butler, Chair of MRSA Action UK, join Adam Thomas on BBC Somerset Breakfast and discuss the controversy over inaccurate recording on death certificates. Sue campaigned for change last year, following the death of her husband and the doctor providing a best guess at his cause of death prior to Sue insisting on a post mortem, the inaccurate cause of death remains on his death certificate. Sue wants the Government to reconsider their response and stop the practice of doctors best guessing the cause of death, and where inaccuracies have occurred, for example including the mention of MRSA or other bacterial infection, a new death certificate is issued.

12th April 2010

LBC Radio 97.3FM

Derek Butler talks to Nick Ferrari on the NHS relaxing bare below the elbows for Muslim staff

NHS relax superbug safeguards for Muslim staff... just days after Christian nurse is banned from wearing crucifix for health and safety reasons
By Jonathan Petre
Last updated at 1:17 AM on 11th April 2010

Muslim doctors and nurses are to be allowed for religious reasons to opt out of strict NHS dress codes introduced to prevent the spread of deadly hospital superbugs.

The Department of Health has announced that female Muslim staff will be permitted to cover their arms on hospital wards to preserve their modesty.

This is despite earlier guidance that all staff should be "bare below the elbow" after long sleeves were blamed for spreading bacteria, leading to superbug deaths.


Scrubbed up well: Surgeons in short sleeves washing hands before operation

The Department has also relaxed its "no jewellery" rule by making it clear that Sikhs can wear bangles, as long as they can be pushed up the arm during direct patient care.

The move contrasts with the case of nurse Shirley Chaplin, who last week lost her discrimination battle against Royal Devon and Exeter Hospital Trust, which said the cross she has worn since she was 16 was a "hazard" because it could scratch patients. Mrs Chaplin, 55, had worn the silver cross on a necklace since her confirmation. But the employment tribunal told her that wearing a cross was not a "mandatory requirement" of her faith, even though Muslim doctors are allowed to wear hijabs or headscarves.

Last night she said of the sleeve concession to Muslims: "I don't believe my cross is a danger so this is double standards. What can you say? It seems that life is stacked up against Christians these days."

Politicians and Christian leaders, including former Archbishop of Canterbury Lord Carey, added that it showed the Government was prepared to accommodate minority faiths while Christianity was marginalised.

Lord Carey said of grandmother Mrs Chaplin: "The Muslim voice is very strong, so politicians and others are scared of it. We can only deduce that the hostility aimed at her is because she is a Christian."

The revised rules, which health officials insist will not compromise hospital hygiene, were drawn up after female Muslim staff objected to exposing their arms in public.

Since the original guidance was announced by the then Health Secretary Alan Johnson in 2007, many hospitals have insisted that staff involved in patient care wear short sleeves at all times.

Mr Johnson's initiative came amid growing concerns about the number of patients catching superbugs such as MRSA and Clostridium difficile. Hundreds of people have died.

The guidance required staff coming into contact with patients to have their arms bare below the elbows, outlawing the traditional doctors" white coat.

Jewellery, other than plain wedding bands and ear studs, watches and false nails, were also banned to cut down the spread of bacteria. But Muslim doctors and medical students said baring arms conflicted with the Koran's teaching that women must dress modestly in public.

In 2008, several universities reported that Muslim medical students objected to the rules.

Leicester University said some Muslim females "had difficulty in complying with the procedures to roll up sleeves to the elbow for appropriate handwashing", while Sheffield University reported a case of a Muslim medic who refused to "scrub" as this left her forearms exposed.

Birmingham University revealed that some students would prefer to quit their course than expose their arms.

A Muslim radiographer quit at Royal Berkshire Hospital in Reading over the issue.

Yet Islamic experts are divided about how Muslim women should dress as the Koran is ambiguous on the matter.

The revised rules, issued on March 26, make clear that staff can wear uniforms with long sleeves as long as they roll them up securely above their elbows to wash and when they are on the wards.

They add that staff who want to cover up completely when dealing with patients will be able to use special disposable "over-sleeves".

The guidance says: "Where, for religious reasons, members of staff wish to cover their forearms or wear a bracelet when not engaged in patient care, ensure that sleeves or bracelets can be pushed up the arm and secured in place for hand-washing and direct patient care.

"In a few instances, staff have expressed a preference for disposable over-sleeves - elasticated at the wrist and elbow - to cover forearms during patient care activity.

"Disposable over-sleeves can be worn where gloves are used but strict adherence to washing hands and wrists must be observed before and after use."

The Department was unable to say last night how much extra it will cost the NHS to provide the disposable sleeves. But 18in polythene over-sleeves are already on offer on the internet for about 7 pounds for a pack of 200.

The Department admitted in its new guidance that it had reviewed its rules because "exposure of the forearms is not acceptable to some staff because of their Islamic faith".

It added: "We recognise that elements of the additional guidance could be seen to be introducing differing requirements for those to whom "baring below the elbows" presents no significant problem.

"We have considered the implications of this possibility but concluded that the overall purpose of the guidance, to ensure patient safety by adherence to good hand hygiene, is not prejudiced by the additional dress options that have now been identified."

Health officials drew up the revised rules on the advice of Islamic scholars and a group called Muslim Spiritual Care Provision in the NHS (MSCP), which is part of the Muslim Council of Britain.

A working party was set up comprising two Health Department officials, a member of the Health Protection Agency, two female Muslim hospital chaplains, an Imam and two members of MSCP. Yet campaigners for the rights of Christian nurses to wear crosses said the Health Department had failed to consult them adequately.

Mrs Chaplin lost her case on Tuesday despite being backed by the Christian Legal Centre and human-rights lawyer Paul Diamond.

She is not the only nurse to fall foul of health-and-safety laws.

Last year, Roman Catholic Helen Slatter, 43, resigned as a blood collector at Gloucestershire Royal Hospital rather than remove her cross which her bosses said "could harbour infection".

Lord Carey, one of seven bishops to sign a letter supporting Mrs Chaplin at her tribunal, said the Government was guilty of "double standards".

"The NHS, British Airways and all the big companies seem to be tilting in one direction, - he added. "If Muslims are getting these concessions, why not Christians? There should be the same rules for everyone."

Lord Carey, whose wife Eileen is a former nurse, added: "In the case of Shirley Chaplin, she has been wearing her cross for 38 years and it has never injured anyone.

"So the argument for health and safety is very weak, very tenuous indeed."

Derek Butler, chairman of MRSA Action UK, a campaign group headed by respected microbiologist Professor Hugh Pennington, said: "We welcomed the introduction of baring-below-the-elbows because we know that anything - whether it's jewellery, watches or wedding rings - can harbour bacteria which can in turn transfer superbugs between patients.

"My worry is that by allowing some medics to use disposable sleeves you compromise patient safety because unless you change the sleeves between treating each patient, you spread bacteria. Scrubbing bare arms is far more effective.

"I've seen doctors and nurses fail to change their gloves, and I've no doubt this will see exactly the same thing happening. These sleeves are just another risk, and you cannot take risks with patient safety."

Former Tory Minister Ann Widdecombe said: "I don't mind if a Sikh nurse can wear a bangle if a Christian nurse can wear a cross. If you have a rule you have to have it for all.

"There is no evidence that crosses are a serious health-and-safety risk. That is just an excuse to discriminate against people of faith.

"Minority groups are unquestionably getting more sensitive treatment than Christians and this is yet more proof."

Dr Andrew Fergusson, of the Christian Medical Fellowship, which represents 4,000 doctors, said: "For some reason, Christians in health care seem to be particularly vulnerable at the moment."

The Department of Health said: "The revised workwear guidance gives further clarity to frontline staff about the need to have good hand hygiene when in direct patient care. It does not change previous policy. The guidance is intended to provide direction to services in how they can balance infection-control measures with cultural beliefs without compromising patient safety.

Read more: http://www.dailymail.co.uk/news/article-1265136/NHS-relax-superbug-safeguards-Muslim-staff--just-days-Christian-nurse-banned-wearing-crucifix-health-safety-reasons.html#ixzz0km0b9cXY


telegraph.co.uk

Muslim staff escape NHS hygiene rule Muslim doctors and nurses are to be allowed to opt out of strict hygiene rules introduced by the NHS to restrict the spread of hospital superbugs
Published: 12:30AM BST 11 Apr 2010

Female staff who follow the Islamic faith will be allowed to cover their arms to preserve their modesty despite earlier guidance that all staff should be "bare below the elbow".

The Department of Health has also relaxed rules prohibiting jewellery so that Sikh members of staff can wear bangles linked with their faith, providing they are pushed up the arm while the medic treats a patient.

The Mail on Sunday reported the change had been made after female Muslims objected to being required to expose their arm below the elbow under guidance introduced by Alan Johnson when he was health secretary in 2007.

The rules were drawn up to reduce the number of patients who were falling ill, and even dying, from superbugs such as MRSA and Clostridium difficile.

Revised guidance which relaxed the requirements for some religions was published last month.

Some Muslim staff and those from other groups may be allowed to use disposable plastic over-sleeves which cover their clothes below the elbow and allow the skin to remain covered up.

Derek Butler, chairman of MRSA Action UK, said: "My worry is that allowing some medics to use disposable sleeves you compromise patient safety because unless you change the sleeves between each patient, you spread bacteria.

"Scrubbing bare arms is far more effective."

A Department of Health spokesman said: "The guidance is intended to provide direction to services in how they can balance infection control measures with cultural beliefs without compromising patient safety."



SUPER-RESISTANT BUG KILLS HOSPITAL PATIENT
University Hospital of North Staffordshire
Thursday April 1,2010

A PATIENT has died after an outbreak of a new drug- resistant strain of a hospital superbug.

Eight people - including the kidney patient who died - developed a strain of ESBL (Extended Spectrum Beta-Lactamase) Klebsiella at the University Hospital of North Staffordshire.

In total, 13 patients on Ward 29, which treats people with kidney problems, were hit by forms of the strain.

Of the 13, two developed symptoms of the infection which can include septicaemia or pneumonia. Hospital microbiologist George Orendi said: "What makes it of concern is the number of patients that we have found with the resistant strain.

"This particular type has not been seen elsewhere."

Enhanced cleaning has been carried out since the outbreak last month, with the patients isolated and screened weekly.

Derek Butler, of patients' group MRSA Action UK, said: "What makes Klebsiella so dangerous is that treatment is so difficult, it's very resistant to antibiotics and very hard to eradicate."


MRSA Action UK issues superbug warning
Monday 29th March 2010

A warning has been issued by MRSA Action UK concerning superbugs in hospitals.

According to the organisation, poor clinical practice is increasing the number of such cases.

It cited research from the Health Protection Agency, which suggested that Clostridium difficile is becoming more acute in community settings.

The inappropriate prescribing of antibiotics was identified as one cause of the trend.

MRSA Action UK - which is a registered charity founded by a group of people who had life-changing experiences or lost loved ones as a result of the infection - suggested that while many cases are taken into hospitals by visitors, not all come from this source.

It recommended educating staff, residents and families on what precautions to take in order to prevent and control outbreaks.

Whichever political party wins the next general election - set to take place later this year - needs to make the control of superbugs a priority, the group said.

Written by Martin Lambert

http://www.mediplacements.com/article-19693932-mrsa_action_uk_issues_superbug.html

Edwina Currie speaks at MRSA Action UK annual meeting at Winsford Lifestyle Centre
8:30am Saturday 20th March 2010

By Frances Kindon

A WINSFORD mother who has campaigned tirelessly since her son died of MRSA, got some very special backing on Saturday.

Mavis Law, of Beckenham Grove, lost son Colin to the superbug in 2003, just days before his 33rd birthday.

Heartbroken, she co-founded the charity MRSA Action UK and former Cabinet Minister Edwina Curry, took time out to speak at its annual meeting on Saturday.

Colin was admitted to the Queen Elizabeth Hospital in Birmingham with haemocromatosis - an iron overload that causes severe liver damage.

He was due to stay for five days while he was assessed for a liver transplant, but five days turned into seven weeks.

Mavis said: "We travelled every other day to visit him and noticed that he was becoming more ill each time - his legs were weeping fluid.

"He eventually became bedridden and needed to remain on oxygen, wired up to monitors, drips and a catheter with three lines going into his groin, a line going into his neck and at one point a feeder going into his nose, his lips were cracked and dry and he had bed sores.

"I will never forget our shock and the pain of seeing Colin's face looking at each of us as we tried to hold back our tears whilst the doctor told us that Colin was dying - that all of his organs were failing - and he also had Pneumonia. No-one mentioned MRSA."


Speaking at Winsford Lifestyle Centre on Saturday, former MP Edwina Currie, who is also the charity's patron, called for more to be done to tackle the killer bug.

The one-time junior health minister in the Conservative government of the late 1980s and early 1990, said: "It has been another busy year for MRSA Action.

"Nobody enters hospital expecting to get sicker, yet 9,000 people a year die as a result of MRSA and other healthcare infections. This is a national disgrace."

Mavis is now the treasurer of charity and son Dale sits as the vice-chair. She praised Mrs Currie for her passion and support.

She said: "Mrs Currie has always been an extremely passionate and active supporter of our work and I'm delighted that she was able to come to Winsford and support our AGM.

"Everyone at our AGM has been affected in some way by a healthcare infection and it takes a lot of courage and strength to come and share their experiences with others. I can't thank those here today enough for taking the time to show their support.

"I would also like to thank other organisations such as Weaver Vale Housing Trust and Cheshire West and Chester Council that have come to give their support to our cause today."

(c) Copyright 2001-2010 Newsquest Media Group

http://www.winsfordguardian.co.uk/news/5066846.Heartfelt_thanks_from_MRSA_charity/


NHS CRISIS: THE KILLER BUGS THAT INFECT OUR WARDS
Tuesday, 16 March 2010
I found dried blood stains on my girl's sheets... days later she died of MRSA

AN NHS hospital should be a place where lives are saved - not ended prematurely by a superbug.

But despite Labour health spending soaring from 37billion in 1997 to 120billion last year, killer infections such as MRSA and C. diff are rife on wards.

The extra cash has led to the number of medical staff rising by just two per cent - while managers are up ten per cent.

SUN gives the NHS a check-up, highlighting problems politicians need to be tackling

A special YouGov survey of 1,747 adults commissioned by The Sun shows people rate superbugs as one of the NHS's biggest problems.

Here, in Day Two of our NHS health check, three relatives of patients who died of MRSA tell DAVID LOWE and JENNA SLOAN of their heartbreaking experience of the NHS under Labour.


Sue Fallon, 44

UNIVERSITY housekeeper Sue, of Newcastle-under-Lyme, Staffs, lost her 17-year-old daughter Sammie to MRSA in May 2008. She says:

Sammie was diagnosed with auto-immune liver disease when she was 11, and although she had to take medication daily she was healthy and lived a normal life.

She was studying photography at college and loved chatting to pals.

On April 3, 2008, she was feeling poorly after a virus so I took her to North Staffs University Hospital.

Blood tests showed she had an imbalance which needed chemotherapy treatment.

They took a bone marrow sample from her hip and started on the chemo.

The first two wards Sammie was in were filthy.

There were sticky patches on the floors and instead of changing the bedding properly, the nurses just took the bottom bed sheet, put it on top and then put a new one underneath.

I came in once and found dried blood stains on the sheet covering her.

It was also difficult to communicate with the nurses as their English wasn't great.

My mum mentioned the problems to a nurse, but Sammie asked me not to complain as she was worried something would be said to her when she was on her own.

I noticed the wound on her hip where they'd done a bone marrow test had swollen up and I was told she had MRSA on May 1.

I had no idea what it was and a nurse just gave me a leaflet.

But my mum used to be a nurse and the look on her face said it all.

They had done the MRSA test on April 29 and in my opinion she should then have been put in isolation.

There were women on her ward with leukaemia who were at massive risk and Sammie's immune system was weak too.

But instead she was moved into isolation on May 2, where she started getting more and more poorly.

Her kidneys packed up and I couldn't believe my little girl, who'd been quite healthy before her hospital stay, was now unconscious and covered in tubes.

She'd had a great chance of recovery but now the consultant was saying she had just a ten to 20 per cent chance of survival.


She died on May 9.

I miss her terribly and so does her little sister Alex, who is 14.

The Government have not done enough to tackle MRSA.

People think it's gone away but there seems to be a new scandal every day.

I don't want any other mum to go through the pain my family has. More....


Rising obesity prompts higher antibiotic doses call
Emma Wilkinson
Health reporter, BBC News
Friday, 15 January 2010

Patients may have to be prescribed higher doses of antibiotics because of rising rates of obesity, say doctors.

The standard "one-size fits all" dose may not clear infection in larger adults and increases the risk that resistance will develop, they argue.

More work is needed to guide GPs on how and when to alter doses, an editorial in The Lancet to accompany the study by doctors from Greece and the US says.

GPs said it was an interesting theory but may end up being expensive.

Around one in four adults in England is classified as obese - an increase from 15% in 1993.

Patients are getting taller and larger and it does seem right that patients are given the appropriate strength of drug

Professor Steve Field, Royal College of GPs Given the fact people are getting larger, use of standard doses of antibiotics in all adults, regardless of size, is outdated, argue two doctors from Greece and the US.

Size and even the proportion of body fat a person has, can affect the concentration of antibiotics in the body, potentially reducing how effective they are in larger patients, they say.

And failure to clear an infection because too small a dose is given may raise the risk of resistance - already an increasing problem for doctors.

Likewise, smaller than average patients may get too much drug, and suffer greater side-effects as a consequence.

Guidance

An accompanying editorial said dose adjustments could easily be made if research was done to guide doctors in treating obese patients.

Professor Steve Field, chair of the Royal College of GPs said he would encourage "appropriate" antibiotic prescribing and lots of patients are given them unnecessarily.

But he added: "Patients are getting taller and larger and it does seem right that patients are given the appropriate strength of drug.

"However, this might cost a lot of money because pharmaceutical companies would have to provide different doses of medication.

"At the moment, most come in two strengths and we would not want to see an increase in costs." He added that GPs will already use their judgment to alter medication doses where necessary.

Professor Hugh Pennington, an expert in antibiotics from the University of Aberdeen, said antibiotics would differ in how size altered their effectiveness.

"But studies on this would not be hard to do.

"If you have too little of a drug it's not going to be good for treating the infection but it also raises the possibility that the organism will become resistant. "They're such powerful drugs, we want to make sure we are using them properly."

(c) MRSA Action UK April 2010


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