Hospital Acquired Infections.... where next?

Research recently published by The Lancet found that in hospital wards tackling superbug outbreaks, MRSA could be detected on dozens of surfaces.

Of the sites tested, 41% of bed linen was found to be contaminated, along with 40% of patients' clothing, and 27% of furniture, including bed frames1.

This will come as no surprise to many - even with excellent cleaning regimens and procedures it is impossible to control the constant movement of staff, visitors and patients around the environment.

Anyone working in a clean room environment will be very familiar with this problem; as soon as you open the door you compromise sterility, let alone if you start touching things.

An obvious part of the solution to health care associated infections (HCAIs), therefore, must be to decrease the number of places that bacteria can survive, grow and develop - breaking the critical 'chain of infection' currently causing so many problems.

A study has found that an antimicrobial treatment, which could be incorporated into dozens of surfaces on the ward, can kill MRSA and c.difficile on contact, reducing the risk of infection between patients2.  Scientists hailed the discovery by researchers from Imperial College London as a 'very significant' step in the war on hospital superbugs which kill 10,000 people a year.

The study found the product was 1,000 times more potent than its rivals in eliminating MRSA, and could be used on dozens of surfaces, creating environments which eradicate bugs instead of harbouring them.

Paint, light switches, medical equipment, staff uniforms and even pens and paper could be treated with Cliniweave, which uses a technique invented by a British company to incorporate an antimicrobial compound into textiles.  Cliniweave has been specifically developed to reduce any chance for further bacterial resistance by uniquely employing a triple class mechanism of action - ensuring rapid and complete bacterial death.

The five-year study, published in the International Journal of Antimicrobial Agents, found that within 60 minutes the treatment eliminated MRSA entirely. In tests on three rival treatments, the bug continued to multiply. 

Professor Mark Enright, professor of microbiology at Imperial College London, which carried out the study, said: 'The results are very promising; a fabric that can kill bacteria on contact could be a really significant way to reduce levels of infections in hospitals'.

The leading infection expert said professionals had long known that different parts of the ward could form 'hotspots' for infection, but said treatments for surfaces had shown limited effectiveness until now.

Hugh Pennington, Emeritus Professor of microbiology at Aberdeen University, said the study findings appeared to be 'extremely significant'.

He said: 'We know that MRSA is often found on surfaces in hospitals, and anything that we can do to reduce the number of places from where patients can become contaminated should be pursued when so many lives are at stake.'3

The Department of Health remain committed to tackling the critical issue of infection control, and despite impressive improvements in hospitals across the UK, a credit to the NHS and staff, improving cleanliness and reducing HCAIs remains the number 1, Tier 1 priority set-out in the Operating Framework for 2009/2010.

References
1.       Preventing and controlling healthcare-associated infections, The Lancet, Vol. 372 No. 9656 p 2088, Dec 20 2008

2.       Simon J. O'Hanlon and Mark C. Enright, A novel bactericidal fabric coating with potent in vitro activity against meticillin-resistant Staphylococcus aureus (MRSA), International Journal of Antimicrobial Agents

3.       Donnelly,L, Curtains and pyjamas to become weapons against superbugs. The Daily Telegraph, Feb 28 2009

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