More on superbugs

Margarent McCartney's article in the Financial Times on superbugs is well worth reading.  In particular, this section gets at how the inexperience and lack of subject knowledge associated with political management is crucial to the failure to control hospital infections:

"Politicians are tackling MRSA with campaigning zeal. Gordon Brown has pledged to instigate a “deep clean” of hospitals to reduce hospital-acquired infection such as MRSA. Health secretary Alan Johnson is setting up a committee to look into the issue and has also said healthcare staff should be unclothed below the elbow. Unfortunately, there is the delicate issue of evidence for these politically inspired “initiatives” which is not so apparent. Johnson’s statements on uniforms seem to contradict a publication from his own department, “Uniforms and Workwear”, which says “there is no conclusive evidence that uniforms pose a significant hazard in terms of spreading infection”.


Lack of handwashing might seem an obvious culprit, but at a lecture I attended recently, the futility of pursuing this as a cure-all was made apparent. “Handwashing does make a difference,” says Dr Stephanie Dancer, a consultant microbiologist in Glasgow, “but think. The doctor washes his hands and then pulls close a curtain. The curtain is covered in MRSA. Or he touches the bedside cabinet. That’s not been cleaned recently either. And there you have it, the transmission of MRSA.” Dancer says that while cleaners do a sterling job in tackling all general surfaces and floors, they are not responsible for cleaning lockers, bedside tables and curtains. “In addition”, she says, “there aren’t enough cleaning hours and there are problems with recruitment of domestic staff. The latter is understandable when you look at pay. You could go and stack shelves in a nice clean supermarket for more.”

Unlike most politicians, Dancer is an expert on the subject. One thing is for sure, none of us is sterile. We are all covered in millions of bacteria and shed thousands of them with each step we take. “Probably 5 per cent of us carry MRSA. But where there are outbreaks of MRSA, it doesn’t seem to be the ‘staff’ strains that usually infect patients,” says Dancer. Many factors affect how and where bacteria are spread. Ward design is crucial and inadequate maintenance can make them hard to clean. Open doors or windows create “more turbulent airflow and the possibility that MRSA could be lifted from surfaces and blown all over the ward,” she says. “Fans, very popular in hot wards, are very effective in shifting MRSA around.”

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