MRSA and Infection Control

A recent report has shown that Ireland has the third highest rate of incidence of MRSA in the EU. The over-prescribing of antibiotics, poor hospital layout and poor hospital and personal hygiene are the main factors responsible for the high rate of MRSA infection. Following my own experience with MRSA, I concluded that our health service has serious infection control issues to resolve.

Some years ago, I was re-admitted to hospital due to complications (orbital cellulitis) following a complex frontal sinus operation. I was assessed in A&E before being transferred to a 5-bedded general ward. I received intensive IV antibiotics but my symptoms failed to respond to treatment and three days later a nasal swab which had been taken on admission, revealed that I was suffering from an MRSA infection. I was immediately moved to an en-suite single room and barrier nursed in isolation while undergoing specialised intensive treatment. So the delay in getting this result had meant that for three days I had been an infection risk to the other patients in the room. This regrettable situation came about simply because our hospitals do not have adequate funding or the laboratory resources to fast-track MRSA screening, and as a result infection control suffers.

Over the following months my infection gradually worsened and I was to be re-admitted to hospital on three further occasions for treatment, each time being processed through the A&E department before being transferred to a hospital bed. This policy would question infection control strategies. By this stage I was an officially ‘labelled’ MRSA patient and on arrival in A&E, I would be quickly escorted to a tiny walled-off area of the unit. This ‘box’ was the HSE’s answer to infection control and it really was worse than a bad joke. It had no en-suite facility so during the many long hours I spent in this hell hole, I used the same toilet facilities as all the other patients thereby defeating the purpose of isolation. No sign of an infection control protocol here. I used to dread the looks I got whenever I emerged from those four walls.

On another occasion after spending the night in A&E, I was transferred to a single room on a busy medical ward. Again this room had no en-suite facilities and I was expected to use shared toilet facilities. No sign of an infection control protocol here. The following morning I was told I was to be moved to the MRSA isolation unit to complete my treatment as my room was needed for another highly infectious patient. I was not happy about this as I instinctively felt that my own recovery would be compromised by moving to the MRSA unit where there is a high risk of cross-infection. If my room had been needed for a dying patient, I would have obliged but it was not my fault that the hospital didn’t have an adequate supply of individual isolation rooms for infection control. I’m afraid I dug my heels in and refused to move despite the huge pressure applied. I’m usually a very amenable sort of person but on this occasion I’d had enough and wasn’t prepared to risk my own health to facilitate any bed manager. Once the fuss had died down, I was quietly told that I’d earned huge admiration from the medical staff for standing up to the powers-that-be at the hospital.

As it transpired, several weeks later I was again re-admitted to the hospital having developed chronic osteomyelitis in my skull and on this occasion I did end up being transferred from A&E to the MRSA isolation unit. I’ve already written about the slack infection control policy here in another post. This unit was everything I’d feared, and worse but after weeks of treatment there I did get the necessary all-clear to be allowed to complete my treatment elsewhere. I assumed I was being transferred to a single room but you can imagine my horror when I found I’d been put back into the same 5-bedded ward where two months previously, I’d first received the diagnosis of MRSA. I again instinctively felt that I posed an infection control risk to the post-operative patients in the neighbouring beds. Despite a fear that I’d be transferred back to the awful isolation unit, I pointed out my concerns to the staff and luckily for me on this occasion, a single en-suite room was quickly made available. This action however sadly confirmed that my concern was justified.

It really is hard to believe the ignorance and confusion that still exists in the whole area of infection control. Comprehensive updated guidelines have been drawn up but they cannot be implemented because of inadequate resources, sub-optimal infrastructure and a lack of access to relevant expertise locally. Laboratories are chronically understaffed and cannot maintain even routine diagnostic work. MRSA is a huge problem that’s not going to go away unless infection control is properly tackled. In the meantime, the response from the HSE has been to spearhead a campaign to place the onus on patients to ensure that medical staff have clean hands. Proper hand hygiene is a major factor in stopping the spread of MRSA but it should be part of a multifaceted approach. If Ireland is to reduce it’s incidence of MRSA, the HSE needs to stop playing silly games with our lives and declare war on the superbugs.

5 Responses to MRSA and Infection Control

  1. Medifix says:

    I was shocked to read the result of a national study among 302 physicians revealed that while a clear majority of physicians (80%) believe that MRSA is a problem but 20% are still ignorant about the threat. 10% also believe antibiotic will be available(Scoop.co.nz, February 12, 2008).

    If 100% of doctors are not convinced, how are we going to implement changes and bring in rapid reduction of this spreading infection?

    This is a major threat to mankind, unless we educate more people, we will not be able to win this war with germs.

  2. Steph says:

    Thanks for visiting, Medifix

    I agree, education is a key factor in the war against superbugs. Attitudes need to change across the whole hospital community if the battle is to be won.

  3. Each time I read one of your posts I am appalled at the what you reveal. With the high levels of education in Ireland one would truly believe that medical facilities should be first rate.
    I’m beginning to wonder though if there is anywhere that patients are cared for properly. I heard yesterday from a friend about a friend of hers who’d had a severe cycling accident and was left with a fractured pelvis, broken bones, wounds etc. She was left for nearly 12 hours before she was attended to, she was given nothing for the pain. She was only xrayed the following day and once admitted when requiring the bedpan she had to wait for 20 minutes to get it and another 20 minutes for someone to collect it, all the while hanging onto a strap which was her only way of supporting herself. She discharged herself after three days. The horror of this story is that she was paying for private healthcare! If it has become this bad in our private hospitals I shudder knowing what goes on in our state hospitals.
    I think the healthcare system all over the world is failing- and because it’s all a focus on profits and management rather than treatment and patient care. The Hippocratic oath has become the hypocritic oath.

  4. Grannymar says:

    Alas, MRSA is not a glamorous disease!

    Steph you need to Get onto a TV programme and disgrace or call the bluff of the ‘Powers that Be’ in HSE and Politics.

    Come on Bloggers, pull the strings and help her get there. We will all benefit in the end.

  5. Steph says:

    Thanks! AV and Grannymar

    AV – You’re going to be further appalled when I tell you that I do have private health insurance (top level – though I can ill afford it!) and some of what happened above, took place in a private hospital built on the grounds of a large teaching hospital! I can’t prove it, but I’m fairly certain that I contracted MRSA in the private hospital so you’re not safe anywhere! I am going to blog about the public v private systems shortly so keep an eye out as it’s guaranteed to open your eyes even wider!

    And you’re right about the focus being on profits and management. Despite a booming economy in Ireland our health service has suffered huge neglect from successive governments and now all they can do is play ‘patch-up’ rather than ‘catch-up’.

    Grannymar – MRSA sure strips away any glamour from life. Once labelled, you are corralled like cattle into holding pens and only the lucky ones escape.

    It’s funny you should mention going on the airwaves. My son, Robin, tried to persuade me earlier this week, to take part in a live radio discussion about MRSA scandals but I declined on the grounds that I feel people are often ‘used’ to spice up programmes and it’s not always for the right reasons. I like to set my own agenda on how I air my views especially with regard to MRSA where there is so much misunderstanding. My blog gets more hits from MRSA enquiries than anything else so I guess it’s working!

    And yes, yer man was following Irish radio (Newstalk 106) online in Singapore. Nothing much escapes his attention! 😉

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