Hygiene basics may beat MRSA
Publication Date:01/11/2007
Cleaning commonly used objects, such as stethoscopes, computers and door handles, and making sure medical staff wash their hands, could be the best ways of beating hospital superbugs, an expert says.
What is MRSA?
MRSA is a type of bacteria, called methicillin-resistant Staphylococcus aureus. It's often called a superbug, because it can't be killed by some commonly used antibiotics. MRSA infections can be treated, but only with carefully chosen antibiotics, which can have side effects and may need to be given through a drip (an IV).
About a third of people have MRSA or similar bacteria living harmlessly on their bodies, often inside their noses. But in some people, MRSA can cause illnesses. These can range from an infected cut to more serious problems, like pneumonia or blood poisoning. MRSA infection has become a particular problem in hospitals.
Why is MRSA a problem in hospitals?
MRSA can spread easily in hospitals, for several reasons.
MRSA can spread by touch from person to person. Also, the bacteria can contaminate objects through touch. MRSA has been found on hospital floors, door handles and taps.
Sheets, gowns and hospital bedside tables are very likely to get contaminated with MRSA, because they are in close contact with patients. Also, electronic equipment (like scanners and monitors) is regularly used near patients, so may get contaminated. Complicated electronic equipment may be more difficult to clean than flat surfaces like floors and tables.
People in hospitals are also more vulnerable to infections. Hospital patients may be elderly or have an illness which has weakened their immune system. Common hospital treatments that break the skin, such as drips or injections, may make it easier for MRSA and other bacteria to get inside people's bodies.
All these things mean that hospital wards are an ideal place for MRSA to spread, especially if they're busy or crowded.
Where does the study come from?
The review of the research on hospital cleaning was written by Stephanie Dancer, a microbiologist at Southern General Hospital in Glasgow. It appeared in a journal called The Lancet Infectious Diseases, which is published by a company called Elsevier.
How bad is the problem?
Latest figures show that, in England, 6,381 people became seriously ill with an MRSA infection between April 2006 and March 2007. These numbers are down a little on the previous year.
What can hospitals do to prevent MRSA infections?
An expert report has looked at how hospitals could stop the spread of MRSA. It says that getting hospital staff and visitors to wash their hands is the best way of preventing infections. But if the hospital environment stays contaminated with MRSA, people will pick up the bacteria again soon after washing. So hospital cleaning also has a vital part to play.
Outside the body, MRSA can easily be killed using hot water or ordinary disinfectants. There hasn't been much research on whether cleaning affects MRSA infection rates. But, the report says, this may be because common sense tells us that hospitals need to be clean.
Some research does show that cleaning helps to control MRSA when used alongside other measures, like screening patients for infection. More intense cleaning, such as closing wards for thorough cleaning, or increasing the hours of cleaning paid for, may also reduce the numbers of MRSA infections.
But if the time and money to be spent on cleaning are limited, the report says that targeted cleaning may be better at controlling MRSA than making sure wards look clean. Cleaning should focus on objects that people touch regularly. These include bed rails, bedside lockers and the alarms patients use to call a nurse.
From:
Dancer SJ. Importance of the environment in meticillin-resistant Staphylococcus aureus acquisition: the case for hospital cleaning. The Lancet Infectious Diseases. Published online October 21 2007.
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© BMJ Publishing Group Limited ("BMJ Group") 2007. All rights reserved
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