fighting a superbug

by Professor Peter Borriello

Most of us have suffered from boils or pimples. The germ that usually causes these is called Staphylococcus aureus. The name is derived from the Greek for a bunch of grapes, because that's what it looks like under the microscope, and it has a golden colour – aureus – when grown in the laboratory. About a third of us carry this germ in our nose, where it rarely causes problems.

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In the 1950s and 1960s, a more dangerous strain emerged which spread around the world causing, in particular, wound and skin infections in hospitalised patients and even in doctors and nurses. Unfortunately, we do not understand why such strains appear to be more dangerous, although it may be due to their ability to produce a number of toxins. The appearance of this strain resulted in a great deal of activity in hospitals to stop its spread.

During the course of the last 50 years many antibiotics have been developed which can be used to treat staphylococcal infections. Unfortunately, some germs have become resistant to these antibiotics. The more resistant of these germs are called methicillin- and multiple antibiotic-resistant Staphylococcus aureus – the so-called MRSA 'superbugs'.

When these germs get into patients in hospital, particularly those who have recently had a major operation, serious infections can happen. Fortunately, the majority of patients do not get infected. However, there has been a steady rise in the number of patients dying from this infection as well as an increase in the numbers where the infection contributed to the death. There has also been a 25-fold increase in the number of patients getting a blood-stream infection with MRSA as a result of being in hospital.

There are many reasons for this. One is that we are now better able to keep extremely sick patients alive and in many cases ensure their full recovery. Unfortunately, while very sick, they are also at their most vulnerable from infection. This situation is made worse by the fact that probes, lines and drips frequently have to be put into the body, all of which breach our normal defences and can act as tunnels for germs.

Another reason is that hand washing amongst hospital staff could still be improved. This simple procedure can be very effective, but the design and availability of facilities for regular hand washing are not always optimum. Good hand-hygiene is very effective for reducing all sorts of infections, including food poisoning, and should also be adopted at home.

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Health Protection Agency Central Office
The Adelphi Building
John Adam Street
The Strand
London WC2N 6HT
Tel: 020 7339 1300
E-mail: webteam@hpa.org.uk
Website: www.hpa.org.uk
The Health Protection Agency is an independent body that protects the health and well being of everyone in England and Wales. The Agency plays a critical role in protecting people from infectious diseases and preventing harm when hazards involving chemicals, poisons and radiation occur. Also prepares for new and emerging threats, such as a bio-terrorist attack or a virulent new strain of disease. A factsheet about MRSA can be found on the website at www.hpa.org.uk/infections/ ...

MRSA Support
46 Great Stone Road
Northfield
Birmingham B31 2LS
Tel: 0121 476 6583
E-mail: info@mrsasupport.co.uk
Website: www.mrsasupport.co.uk
A support group for sufferers of MRSA and their dependents, they also campaign for a cleaner approach to hospital hygiene. The website provides information about MRSA as well as some practical dos and don'ts for your time in hospital.

Patients Association
PO Box 935
Harrow
Middlesex HA1 3YJ
Helpline: 08456 084455
Tel: 020 8423 9111
E-mail: mailbox@patients-association.com
Website: www.patients-association.com
Information for patients, along with a database of useful organisations. The website also has surveys, polls and articles from guest writers.

(May 2004, resources updated January 2005)