Probe finds 'frightening' MRSA levels at ERI

Published on Friday 3 June 2005 12:08

DANGEROUSLY high levels of the killer superbug MRSA have been found in Edinburgh Royal Infirmary following an Evening News investigation.

Samples recovered from wards and public areas reveal concentrations of MRSA up to four times above the accepted danger level.

Secret testing was carried out using sterilised slides coated with a special sticky gel on each side which were pressed on to surfaces within the flagship hospital.

The slides were provided by microbiology research firm Chemsol Group Ltd which oversaw the investigation, ensuring tests were carried out to professional standards. They were sealed and returned to Chemsol within 48 hours where subsequent laboratory examination revealed the presence of MRSA in eight out of ten samples.

Colonies of the deadly bacteria were discovered everywhere from a patient's dressing gown in a ward for severely ill elderly people to a payphone in the main reception area. None of the slides picked up any evidence of disinfectant.

A leading expert on MRSA said the results were "frightening" and accused health chiefs of neglecting infection-control procedures. Up to 0.1 colonies of MRSA per square centimetre is considered low risk, medium risk is 0.1 to 0.5 units and high risk 0.5 and above. Anything more than 0.5 is seen as a serious danger.

Among the highest levels of the superbug detected were found in Ward 203, which houses elderly patients with chronic lung diseases such as bronchitis. The vulnerable condition of the patients puts them at greater risk of dying from the infection.

A bedside chair and bed linen there gave high-risk levels of 0.7 and 0.6 respectively. A dressing gown showed a medium risk level of 0.3. The superbug was also found at a medium-risk level of 0.4 on a toilet handle in a day surgery waiting room for patients undergoing minor operations - again exposing them to a greater risk of catching the superbug.

The highest levels of all were discovered on a hand-basin tap in a public toilet near the hospital's main restaurant. The reading was 2.3 - more than four times the 0.5 serious danger limit.

A sign on the wall showed that a routine cleaning inspection was almost an hour and a half overdue when the tests were carried out.

The shocking findings mean that countless visitors, patients and staff washing their hands in the belief that they are helping prevent the spread of MRSA are actually unwittingly spreading the bug by using the unclean tap - putting ERI patients at risk of infection, including accident victims and newborn babies.

Dr Chris Malyszewicz, a leading microbiologist who set up Chemsol Group Ltd to help combat MRSA, analysed the ERI slides.

He said: "Hospitals should operate a zero tolerance policy against MRSA. Really the danger levels are anything above 0.1 [colonies per sq cm]. Anything above 0.5 could be considered highly dangerous. The tap sample was 2.3, which is at very high danger level. Anyone using that basin to wash their hands could inadvertently pick up MRSA when they touch the tap to turn it off.

"That is the stupidity of it. People think they are doing the right thing by washing their hands but when they switch the tap off they are picking up MRSA which they will carry with them into wards and transmit it to patients. I would say that the hospital is neglecting infection control. I think people should be dead frightened by the results of these tests."

THE superbug is a bacteria which occurs naturally in around 30 per cent of the population without ill effect and is generally found in nasal passages, ears, armpits, groin and sometimes on hands.

MRSA only causes an infection when it comes into contact with an open wound, which can be as small as a scratch, although it can pass through frail skin - putting the elderly at risk. An estimated 400 patients a year in Scotland die from MRSA infection.

The Evening News investigation was carried out just days after health chiefs launched a probe into public complaints about poor cleanliness standards and patient neglect.

Nancy Brown's 76-year-old mother was a chronic lung disease patient in Ward 203 last week when the News investigation found high levels of MRSA on her bed linen and a bedside chair.

Low levels of the superbug were found on her dressing gown. Mrs Brown, a 51-year-old IT administrator, said: "The fact that MRSA was on her dressing gown when she'd only been in the ward about five hours is quite worrying. She and the other patients in there were all frail women aged 70-plus with severe lung diseases. They are all very vulnerable."

Dr Malyszewicz says the solution is simple: "Hospitals should start using proper disinfectant. I think the only way you can break the cycle of MRSA going in and out of hospitals is to introduce disinfectant showers which everyone must go through. They should also install electronic taps so people don't need to touch the tap."

A spokeswoman for NHS Lothian said the health board was proud of its record on combating MRSA. She said: "NHS Lothian is a leader in the fight to keep it [MRSA] out of hospitals."

The health board declined to comment on whether or not it uses disinfectant or on whether it plans to implement any of Dr Malys-zewicz's suggestions on improving infection control.

Brian Cavanagh, chair of NHS Lothian, said: "Reducing healthcare-associated infections such as MRSA is a key priority for NHS Lothian. That is why we introduced alcohol gel in ERI wards some time ago.

"We have taken many other measures including a public information campaign on what visitors and staff should do to keep these kind of infections off our wards.

"I hope the Evening News will now support us in attempting to continue to inform the public on how we can work together to fight these infections."

THE FACTS

MRSA stands for methicillin-resistant staphylococcus aureus. Its name refers to the fact that it is resistant to most antibiotics, which has led to it being dubbed a superbug because it is more difficult to treat than other bacterial infections.

There are two main types of MRSA bacteria. Hospital strains are even more virulent than community strains, making them even more resistant to antibiotic treatment. In an Evening News investigation into MRSA levels at the Edinburgh Royal Infirmary, sterilised slides were pressed on to surfaces around the hospital, picking up any bacteria on a special gel coating. The slides were then placed in sterilised tubes and sent within 48 hours to the Northampton-based microbiology firm, where leading MRSA expert Dr Chris Malyszewicz analysed them in a laboratory. Checks found two hospital strains of the superbug, E15 and E16, in all but two of the ten samples taken in the ERI.

Latest statistics show that a patient has a one in 368 chance of contracting MRSA during a ten-day hospital stay in the Lothians, the third-worst rate in the country.

In May, NHS Lothian was named and shamed for failing to meet one third of targets aimed at stamping out deadly hospital bugs. Inspectors from NHS Quality Improvement Scotland (QIS) said the health board was only meeting 46 out of the 68 criteria required to tackle infections like MRSA.

However, inspectors also praised Lothian hospitals for being one of only a quarter in the country tocomply with guidance on hand washing - a major step in the fight against the spread of infections.

In March, the Scottish Executive announced a 15 million, three-year campaign to protect patients from hospital infections. Key elements include placing alcohol handrubs by every frontline bed and putting sisters and charge nurses back in charge of ward cleanliness.