The bacterium actually exists quite harmlessly on the skin of millions of Britons. But its growing resistance to antibiotics, combined with the increased pace and complexity of modern healthcare, have turned it into a potential killer once it enters the bloodstream.

In the last decade the bug has been responsible for nearly 10% of all hospital-acquired infections. It is believed to kill 1,000 patients each year in UK hospitals – one of the worst records in Europe. The government has launched a series of high-profile initiatives aimed at halting the disease in its tracks. They include the ‘wash your hands’ campaign, a programme of ‘deep cleaning’ of all wards and even proposed new guidelines on doctors’ and nurses’ uniforms.

Latest figures show a welcome overall drop in MRSA infection rates but it is nowhere near enough to hit the government’s target of halving the rate by next year.

Claire Rayner is President of the Patients’ Association.
She contracted MRSA in hospital:
“In the past few years, I’ve spent more time in hospitals than I care to remember. After what I’ve seen and experienced, I would have to be seriously ill or in severe pain before I would stay in another.

“The main problem is simple: it is a lack of basic hygiene. This infection can live on any object that patients and health professionals touch. If these things are not properly cleaned and made as aseptic as possible they will pass on infection. Doctors and nurses need to go back to the techniques originally devised by Lord Lister in Scotland over 100 years ago and which all health professionals employed as a matter of course.

“Sadly, the government’s over-rigid targets have led to staff, who are already stretched to their utmost, taking shortcuts in patient care. Strong efforts must also be made to supervise nurses at the bedside as well as cleaners to ensure all working surfaces are disinfected at least twice a day.”

Jonathan Fielden represents the British Medical Association’s consultants:
“Probably the single largest cause of our high MRSA rates is the fact we move patients too quickly and don’t leave enough time to decontaminate ourselves and the environment after each patient is moved. Cutting waiting lists and moving patients through the system quickly has been top of the agenda for the last ten to 15 years. That’s what managers are measured against. Also, patients who do have problems are nursed too close to others who don’t. In most hospitals, there aren’t enough isolation and side rooms.

“The Netherlands has virtually no MRSA. They have a very rigid regime of screening, infection control and isolation for patients with hospital-acquired infections, and they have managed to keep MRSA out as a result.

“There is a significant proportion of MRSA in the community. With rapid screening we could isolate those individuals early on.

“We need to redesign hospitals to create smaller bays and increase the numbers of side rooms. Even the new hospitals haven’t got enough.”

Mike Proctor is Deputy Chief Executive of York Hospitals Trust, which has one of the lowest MRSA rates in the country:
“What really transmits infection is poor clinical practice. We had a major focus on hand hygiene. We told staff: cleaning your hands is the last thing you should do before you touch a patient and the first thing you should do afterwards.

“We also encouraged patients to challenge staff about whether they had washed their hands. It didn’t happen as much as we’d expected but the threat was enough. A consultant would only have to be challenged once to change their practice  
a lifetime.

“We investigate every MRSA case and on occasion we’ve been able to trace the infection back to the individual who put the [intravenous] line into the patient and gave them the bug.

“We’ve introduced at least half an hour’s infection control training for every member of staff, including cleaners and kitchen staff. All these things combined have helped keep our rates low.”

Rose Gallagher is the Royal College of Nursing’s infection control adviser:
“We have a significant population coming in and out of hospital that’s constantly feeding the disease. We have to identify which patients may be carrying MRSA, then manage and try to prevent cross-infection. That’s how to break the chain.

“You need good processes in place such as the provision of alcohol hand gel, good leadership and investment. Leadership and role models are vital. Absolutely everybody has a role to play and everyone needs to know what’s expected of them. The key is building infection control into every part of daily life.

“The government’s deep clean initiative makes sense, but I’m not sure how effective a one-off clean will be. Any measure like that needs to be sustained. We know any environment will have bacteria once patients come back into it.”

Compiled by Andrew Cole, a journalist who contributes to Guardian Society, BMJ and Health Service Journal

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