Concerns about MRSA have been raised by the families of two more patients at York Hospital. Mike Laycock talks to health chiefs about this antibiotic resistant strain of a common germ- and the steps being taken to detect and treat it.

IF you thought the germ was only found in hospitals, you should take a look at this statistic: There is about a one-in-three chance you are carrying Staphylococcus Aureus right now on your skin or in your nose, without it causing any problem at all.

Alarmed? Well, you needn't be, because for most people the bug, including the antibiotic resistant strain Methicillin Resistant Staphylococcus Aureus (MRSA), holds no problems for those who are fit and well, says York Hospitals NHS Trust chief executive Jim Easton.

But for very sick people, it can be a risk, particularly if they have open wounds or need to have a drip, drain or catheter attached to them. These provide a potential entry point for the germ to get into the bloodstream and develop into an infection.

This is why potentially vulnerable patients are screened for the presence of MRSA when they arrive at York Hospital.

"By rigorously screening these patients we can find out if they have brought MRSA into hospital with them on their skin," said Mr Easton. "If we detect MRSA on these patients, we can do everything possible to protect them and our other patients."

Swabs are taken to check for the germ, and the screening process helps to pick up patients carrying the germ -about 20 to 30 patients per month - in high-risk areas or before an operation.

If it is found to be present, a series of precautionary measures are taken, both to prevent the patient concerned from developing an infection if MRSA enters the bloodstream, and also to protect other patients who might be at risk.

Patients are nursed in a single room or low-risk bay, and asked to restrict their movements, and they are washed with an antiseptic solution to cleanse the skin of MRSA. If the germ is present in the nose, a nasal ointment called Bactroban is applied.

Aware that anyone can be carriers, including hospital workers such as doctors and nurses as well as visitors, steps are taken to combat the risk of them passing on the germ.

Mr Easton said the hospital had piloted a national "clean your hands" campaign to improve hand hygiene across the hospital, which had now been adopted in hospitals across the UK and is proving to reduce MRSA rates.

"This includes the use of the alcohol-based hand gels, which are proven to provide one of the most effective means of helping to reduce spread.

"The alcohol gels are available at every bedside and throughout wards for staff, patients and visitors to use."

Mr Easton stressed there was a significant difference between MRSA being carried on someone's skin and being infected by it when it entered the bloodstream.

He said the hospital had cut the rate of MRSA infection from 32 cases in 2003/04 to 26 in 2004/05. "Making sure we continue to drive down our MRSA infection rates remains a priority for the trust and infection control team".

The Evening Press recently reported how a patient at the hospital had been treated for MRSA. Since then, the families of two other patients have contacted the paper to say their relatives had also been treated for it. Both patients were carriers of MRSA and were not infected, because the bacteria had not entered their bloodstream.

The daughter of a woman in her 90s said she was shocked to discover MRSA had been found on her mother's legs while she was staying in York Hospital earlier this year after being admitted for a hip operation.

She said she found out about the MRSA by a friend who had been told by nurses, and she felt the matter had been sweep under the carpet. "I was angry no one had told me."

The daughter of a woman in her 50s claimed her mother was found to have MRSA on bed sores twice within the space of a few weeks last year.

"We're very annoyed and upset," the daughter said. "You expect to go into hospital to get better."

She also criticised cleanliness at the hospital, claiming staff left bottles of urine emptied from a catheter on the floor of the ward along with soiled sheets.

"The standard of cleaning within the hospital is diabolical," she said. "Surely this all adds up to the increasing problem of the superbug and aids the spread of infection."

The trust said today that some patients were carriers of MRSA on admission and others could develop it as a result of a severe illness, requiring antibiotic treatment.

It said neither of the patients were infected by MRSA because it had not entered their bloodstream.

Due to patient confidentiality, it was unable to comment further on individual treatment without patient's permission.

"We know patients may be worried by their screening test results, but we would like to reassure these patients that it is not the hospital which is responsible for the MRSA being present on their skin," said Mr Easton.

Mr Easton stressed that hospital cleanliness was a priority for the trust, and said that if soiled sheets and bottles of urine had been left on a floor, as claimed, this was unacceptable.

However, he said there was no evidence nationally to directly link hospital cleanliness to MRSA infection rates.

"We do take any concerns people may have about hospital cleanliness very seriously, and as a result it is an area we monitor very closely," he said.

He said the hospital's cleanliness had been found to be "satisfactory" during its most recent inspection, but his target was to get an "excellent" rating.

Superbug factfile:

What does MRSA stand for: Methicillin Resistant Staphylococcus Aureus

lWhat is it?

An antibiotic resistant strain of a common germ called Staphylococcus Aureus, which many people carry on their skin. It holds no problems for those of us who are fit and well but can be a risk to those who are very sick and require drips, drains, catheters and antibiotics

MRSA is harder to treat because it is resistant to common antibiotics, so special ones have to be used

Most people carry the germ and are not infected

How many cases are detected at York Hospital? About 350 patients are found to be carrying it each year, several of whom are admitted to hospital with it

How are patients treated? Antiseptic solution is used to cleanse skin and a cream applied for nasal carriage. Patients isolated to prevent spread of germ.

What else is done to prevent spread?

Alcohol-based gels are available at every bedside to keep the hands of patients, staff and visitors clean

How many patients become infected at York Hospital? 32 cases in 2003/04, down to 26 in 2004/05. Target is down to 12 by 2008

The above patients and their relatives were invited by the trust to come and meet hospital staff and discuss their concerns, but they declined

Updated: 09:48 Monday, May 02, 2005