NNUH has lowest MRSA rate in the county

Latest figures released today by the Health Protection Agency reveal the Norfolk and Norwich University Hospital had the lowest MRSA rate in the county and one of the lowest rates in the region.

From April 2008 to September 2008, the Norfolk and Norwich University Hospital, which is the busiest hospital in the region, has had the lowest MRSA rate in the county and one of the lowest rates in the East of England.

Source: HPA, April 2008 to September 2008. MRSA bacteraemia rate per 10,000 bed days.

The rate of MRSA infection has been more than halved in the last three years from 64 bacteraemia infections in 2003/04 to six cases in the first six months of 2008/09. The Trust's target is no more than 26 cases this year while treating over 126,000 in-patients.

Dr Judith Richards, Consultant Medical Microbiologist and Director of Infection Prevention and Control at NNUH, attributed the current fall to the Trust's zero tolerance approach to infection. She said: “There has been a culture change from accepting the infections happen to a zero tolerance approach but there remains no room for complacency. Infection prevention and control is everybody's business and we are all committed to reducing the risk to our patients from the board room to the wards.

“MRSA is one of the more well known infections but there will always be new organisms which will develop and sweep through the community. These infections then show up in hospitals where older patients and those with complex health problems are more vulnerable to infection.

“This has led us to develop a series of measures such as patient screening programmes, staff training, and regular audit which help us to maintain high standards. Keeping the environment clean, hand-washing and using single rooms to isolate patients with an infection are also top priorities.”

The Trust has this year expanded its MRSA screening programme to all patients undergoing elective (planned) surgery. The Department of Health assumes that between 7.5 per cent and 10 per cent population may be colonised by MRSA which can be carried on the skin without any health problems. Data from the NNUH screening programme indicates this figure is closer to two per cent locally. The bacteria can cause an infection when a patient has a deep wound or the skin's defences are penetrated by equipment, such as an intravenous drip.

Patients who are colonised by MRSA are offered a special antibacterial skin wash and cream for the nostrils which helps to clear the bacteria prior to hospital admission and reduces the risk of an infection.

The Trust has also seen rates of another infection called Clostridium-difficile (C.diff) continue to fall during 2008. The Trust's target is to have fewer than 20 cases a month and last month there were just four cases.

This infection is associated with repeated antibiotic use in patients who have a chronic health condition. The antibiotics are often necessary to help patients recover from illnesses such as chest or kidney infections. In turn, these drugs can wipe out the good bacteria in the gut, leading to severe diarrhoea caused by the growth of the c-difficile bacteria. The rate of infection is reduced by changes to antibiotic prescribing, the use of isolation rooms, and deep cleaning of infected areas, as well as scrupulous hand hygiene.