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Marie Shields

Wired world

Right now, you’d think electronic health records would be the last things on anyone’s mind. A raging pandemic of swine flu, rock icons dying in mysterious circumstances amid rumors of prescription drug abuse, hospital-acquired infections still causing serious problems – there are so many other health-related stories dominating the headlines. And yet EHRs remain top of the agenda, and rightfully so.
07 Oct 2009

Hospital viruses - What are you at risk of?

Jodie Humphries

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Hospitals are placed to get better, not get ill. But hospital viruses are a very real problem and, according to a cross-party group of MPs, the UK government has now taken its "eye off the ball" on hospital infections other than MRSA and Clostridium difficile.

The Public Accounts Committee said setting targets in England for the two infections had led to a fall in cases. But despite this, they warned that other bugs - such as E.coli - were becoming more common, calling for better surveillance to curb the problem.

More than 300,000 patients in England catch an infection linked to their healthcare while in hospital each year. To treat, these infections cost the NHS more than one billion pounds a year, according to the report.

The Department of Health said it was already looking into the issue. A spokesman said to the BBC, "We recognise that surveillance of other infections could be improved."

In England, MRSA rates are now a quarter of what they were at their peak in 2004, while C. difficile rates have fallen by nearly a third in the past year, following the introduction of targets.

But the MPs said these only accounted for about a fifth of the total number of all infections seen in hospital.

While MRSA is the most high-profile bloodstream infection, E. coli is much more common and has actually increased by a third in the past four years, the report said.

Possible hospital viruses

Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterium responsible for several difficult to treat infections in hospitals. In hospitals, patients with open wounds, invasive devices, and weakened immune systems are at greater risk for infection than the general public. Hospital staff who do not follow proper sanitary procedures may transfer bacteria from patient to patient.

Clostriduim difficile is a bacterium which can be found in low numbers in the intestine of a small proportion (less than five percent) of the healthy adult population. Normally the 'good' bacteria in the intestine stop it causing any illness. When antibiotics are given to a patient with C.difficile in the intestine, the 'good' bacteria may be damaged, and this may allow C. difficile to produce an inflamed intestine (colitis) producing diarrhoea, or sometimes more serious symptoms. The bacterium produces two toxins, which are responsible for the diarrhoea and which damage the cells lining the intestine.

Escherichia coli (E. coli) is a species of bacterium which is found in the intestines of animals and humans, of which there are many different types. Some live in the intestine harmlessly, but other can cause a variety of diseases, including cystitis, meningitis and diarrhoea. The bacterium is found infaeces and can survive in the environment. It is usually transferred to humans by ingesting contaminated water, or contaminated food, such as meat, which has not been cooked properly.

E. coli O157 is a particularly nasty strain which symptoms can range from mild diarrhoea to haemorrhagic colitis - a combination of severe abdominal cramps and blood in the stools.

Pneumonia is an inflammatory illness of the lung, which can be caused by microorganisms, irritants and unknown causes. Hospital-acquired pneumonia, also callednosocomial pneumonia, is pneumonia acquired during or after hospitalization for another illness or procedure with onset at least 72 hours after admission.

Hospitalised patients may have many risk factors for pneumonia, including mechanical ventilation, prolonged malnutrition, underlying heart and lung diseases, decreased amounts of stomach acid, and immune disturbances.

Infection Control measures

Infection control measures, such as wearing gloves when caring for patients. In addition, washing with soap and water will eliminate the spores from contaminated hands, but alcohol-based hand rubs are ineffective.

Visitors to patients with MRSA infections are advised to follow hospital isolation protocol by using gloves, gowns, and masks when indicated. Visitors, including healthcare providers, who do not follow such protocols are capable of spreading the bacteria to areas such as cafeterias, bathrooms, elevators, or various other services.

The report

As well as mentioning the other above hospital viruses, it also highlighted surgical site infections, which were twice as common as bloodstream infections, and respiratory and urinary tract infections, which were three times as common.

Committee chairman Edward Leigh said this report was the third time the committee had warned about the threat of other infections, adding it was "disappointing" the issue had yet to be addressed.

"The government has taken its eye off the ball regarding all other healthcare associated infections - which actually constitute most by far of all infections."

The report suggested hospitals start reporting all types of infection and that they look to curb the use of antibiotics.

While the report praised the NHS for reducing cases of MRSA and C. difficile, the report said health chiefs need to get a "better grip" on the other infections. Health authorities still do not collect data on 80 percent of those other infections.


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