MRSA and Super Bugs- Now Wash Your Hands
Superbugs are here to stay. Last year MRSA was the Naomi Campbell of the infection world, this year's Gisele Bundchen is C. difficile. The facts behind the headlines reflect this change -MRSA cases are slowly declining while incidences of C. difficile are on the increase. Both of these infections are known by health professionals as HCAI's which stands for Health Care Associated Infections - what the rest of us call ‘superbugs'.
On the whole, HCAI's are bacteria which have become resistant to the antibiotics once used to control them. That's not to say that they can't be treated by any antibiotics but fewer antibiotics are effective and those that are used need to be given in larger and longer doses. The fear is that soon an infection will develop which will be resistant to all antibiotics.
The other factor which makes HCAI's such a problem is that most of them are commonly found on healthy people or in the environment, just waiting to take advantage of a sick or injured human being. C. difficile, for example is found in the gut of about 3% of healthy adults and up to 66% of infants. MRSA is carried harmlessly on the skin of one in three healthy adults. It only becomes a problem if it gets into the skin or blood stream through an injury.
Infection Control of Superbugs
Infection control has always been a part of hospital policy, but in recent years there has been an explosion of initiatives aimed at bringing down the rate of dangerous infections. Not surprisingly, hospital hygiene has been in the spotlight with groups such as the Patient Environment Action Team, the National Patient Safety Agency and the National Concern for Healthcare Infections all campaigning for better hygiene. Hospital staff blamed politicians for privatising cleaning services, and politicians blamed hospitals for failing to manage their budgets effectively. Hospital matrons were reintroduced and we all had visions of Hattie Jacques bustling about the wards running her fingers along the surfaces to check for dust.
Then, in 2006, came the damning report which found no link between hospital cleanliness and rates of HCAI's. Standards of cleanliness are measured by the Patient Environment Action Team who scrutinise hospitals closely, looking at the cleanliness or otherwise of every surface from floors to light switches, laundry equipment to curtains. Their reports find that hospital cleanliness has improved significantly over the last few years, and yet rates of MRSA are only declining slowly while rates of C. difficile are still increasing. And the reason for this? Hand washing. Or, to be more precise, lack of hand washing.
There are other factors to infection control but it is now widely recognised that the most significant factor is the lack of effective hand washing amongst health workers. This has resulted in thousands of pounds being spent on posters, leaflets, stickers, letters and websites all promoting the importance of hand washing. At the forefront of this revolution is the ‘clean your hands' campaign which began in 2004. Estimates suggest that before the campaign an average healthcare worker would wash their hands just six times a day. Now that number has risen to 16, and any hospital visitor will certainly have noticed the increase in the number of alcohol rub dispensers in most areas. Unfortunately, although alcohol rubs kill most bacteria and do not dry the hands out in the way that soap and water do, alcohol does not kill the bacteria responsible for C. difficile. Perhaps this partly explains why cases of C. difficile are still rising.
Hand Washing and Superbugs
Worryingly, a study published in January 2007 found that hand washing was still a major problem in most hospitals. Researchers followed healthcare professionals for a week and found that 88% failed to wash their hands before and after patient contact. Even more worryingly, 85% failed to wash their hands after contact with a patient known to be carrying MRSA. And clearly, it isn't just how often you wash your hands, but when and how well. Experts say you should wash with soap for at least 15 seconds. Patient leaflets recommend washing for as long as it takes to sing Happy Birthday! One example of poor hygiene was given of a nurse who washed her hands before and after changing a dressing, but didn't wash her hands after removing the old dressing and before picking up the new one. One can't help thinking that our poor nurses are going to have the sorest hands in the world and that increased use of disposable gloves is likely to be more useful.
So what can you do as a patient or as a hospital visitor to help in the fight against superbugs? Wash your hands thouroughly and ensure that other people wash theirs before they have any contact with you and your things.
One more fact; 75% of men admit that they don't always wash their hands after going to the toilet. Those superbugs must be rubbing their hands with glee.
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