Crackdown on hygiene as NHS 'superbug' infections rise to among highest in world

Health Editor,Jeremy Laurance
Saturday 06 December 2003 01:00 GMT
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Hospitals were ordered to improve hygiene on their wards yesterday after NHS infection rates rose to among the highest in the world. Every NHS trust is to appoint a director of infection control who will have the responsibility for cutting deaths and illness caused by superbugs, infections resistant to antibiotics.

The move is part of a tough new strategy aimed at cutting the toll from hospital-acquired infections. Almost one in 10 patients is estimated to catch an infection in hospital and 5,000 die each year. The rate of infection in Britain is higher than in Australia, Denmark, Norway, the Netherlands and Spain and level with that in the US and France.

Five years of advice and guidelines had failed to work, Sir Liam Donaldson, the Government's chief medical officer, said yesterday. Although 12 per cent of trusts had reduced infection rates, most had not and some had got worse. "The message is, there will be no more Mr Nice Guy in the fight against hospital-acquired infections," he said. "We are going to get much tougher and more aggressive."

Sir Liam said hospitals were victims of their own success. Advances in medical care meant older, sicker patients were being treated successfully but their weakened immune systems made them more susceptible to infection.

Some countries had curbed the worldwide rise in hospital infections better than others. The commonest resistant bug in the UK, methicillin-resistant Staph-ylococcus aureus (MRSA), has grown from 2 per cent of all Staphylococcus aureus blood infections to 44 per cent in the past 20 years. MRSA infections are among the hardest to treat and frequently lead to closure of wards and disruption of hospitals. In the Netherlands, a "search and destroy" policy, began in the early 1990s, in which all patients were screened for MRSA and nursed in isolation if it was found, has kept infection rates down to 1 per cent. "This shows there is scope for improvement," Sir Liam said. "If they can do it why can't we? That is the challenge we face."

Rigorous standards of hygiene were at the heart of the policy, based on frequent handwashing, aseptic techniques and minimising use of intravenous lines and catheters which provide access for bacteria. Sir Liam said all patients should have information about hospital MRSA infection rates. "It should be part of a modern patient's expectations so they can make a choice."

The Royal College of Pathologists welcomed the move but warned that the "critically low numbers" of medical microbiologists would hinder progress. The charity Action Against Medical Accidents, which campaigns for better safety, said the impact of MRSA infection on patients and families was "tragic and devastating". Peter Shaw, its chief executive, said: "From what we hear, the infection is so widespread many hospitals have become resigned to it. Often, those affected are told it is just one of those things that happen in hospitals."

John Reid, the Secretary of State for Health, said he was issuing a "call to arms" over the issue. "There is no magic solution. It is about hard work and old-fashioned methods. We should be reducing risks much more than we are doing."

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