Limited success for hospitals in battle against superbugs

The hospital superbug MRSA is in retreat, public health experts said yesterday. The number of bloodstream infections fell 10 per cent last year to 6,381, the third year of sustained decline, as hospitals stepped up efforts to fight the bug.

But there was less good news on Clostridium difficile, the cause of sometimes fatal infections of the gut, with cases rising 7 per cent last year to a record 55,620.

Alan Johnson, the Health Secretary, has ordered trusts to step up efforts to combat infections. He told a conference of senior nurses and midwives yesterday that cleanliness was not an "optional extra" but the "first demand".

He said the first trust to be earmarked for "deep cleaning", involving intensive scrubbing of wards and treatment areas, would be Maidstone and Tunbridge Wells, where an outbreak of C.difficile caused 90 deaths and contributed to another 200-plus over two years from 2004 to 2006. A scathing report into the outbreak, the worst in the UK, published last month by the Healthcare Commission led to the resignation of the chief executive, Rose Gibb.

Mr Johnson announced yesterday that a severance payment believed to be worth £250,000 agreed by the trust with Ms Gibb would be withdrawn after health department lawyers ruled it unlawful. Mr Johnson, who had temporarily halted the payment pending the legal advice, said the trust had failed to gain the "necessary approvals".

The Health Protection Agency, which published its annual report on NHS hospital infections yesterday, was upbeat about the latest infection figures. Georgia Duckworth, head of the healthcare-associated infections department, said cases of MRSA had fallen in each of the past three years. "Not only has this plateaued but it is coming down," she said. "If you had spoken to anyone in the field three years ago they would have said it couldn't be done." She said the high profile given to combating infections, better recording of cases and tighter management to ensure proper cleaning, handwashing and isolation procedures on the wards had all contributed.

But the fall will not be enough to meet the Government's target of a halving in the MRSA infection rate by 2008. While C.difficile infections were still rising year on year, latest quarterly figures for April to June 2007 showed a 7 per cent drop compared with the same period last year.

Dr Duckworth said: "It looks like we might be going into a plateau. Let's hope this marks the beginning of a plateauing that goes into a downturn."

C.difficile is thought to cause 4,000 deaths a year and MRSA more than 1,000. But a study suggested many deaths where MRSA was mentioned on the death certificate may be wrongly attributed to the infection, while others where MRSA was not mentioned may have been caused by it.