Return of MRSA has experts baffled

While NHS Lothian has made good progress in tackling the bug in recent years, the number of cases has crept up lately, ringing alarm bells.

But medics are becoming concerned since being told by infection control experts that they have so far failed to pinpoint why cases are again  rising.

The number of cases being reported overall remains lower than in previous years, with 31 cases of MRSA recorded in 2012, compared with 40 in 2011 and 85 in 2010.

But NHS Lothian’s director of public health and public policy, Dr Alison McCallum, said: “I am concerned that while we have, for two years, seen a constant downward trend in terms of Staphylococcus Bacteraemia and were on course to meet our appropriate target for March 2013, the last three to four months have been problematic.”

There were 28 patients hit by the Staphylococcus aureus Bacteraemia in Lothian hospitals last month including five cases of MRSA – the more dangerous strain of the bug that is resistant to drugs.

The 28 cases in December was the highest number recorded in any month last year, while the five MRSA cases rose from two cases the previous month – the second highest of any month in 2012 – behind the seven cases that were discovered in October.

Dr McCallum said that each case was investigated fully but that so far no trends had been found to give clues as to the reason behind the increase.

She said: “Each of these infections is looked at as avoidable. There is no clear, obvious reason other than the increasing frailty of the population and increased numbers of patients we have.

“We are committed to investigating each individual case and to applying any lessons that can be learned to help minimise the risks of healthcare associated infections.”

To hit targets by March, NHS Lothian must have no more than 17 per month on average, but the recent surge has pushed cases up to 21. Alongside 31 cases of MRSA in 2012, there were 214 cases of the more common but less dangerous MSSA – down from 221 in 2011 and 258 in 2010.

Dr Jean Turner, a former anaesthetist and director of the Scotland Patient Association, said the recent increase in MRSA-type cases should serve as a timely reminder to visitors to hospitals of the importance of hand hygiene.

“They should be congratulated for improvement in recent years but it’s not something to give up on. It’s going to be an ever-present ongoing problem,” she said. “The population coming into hospital changes, visitors change or become complacent. We need to make sure there’s an education programme in every hospital when it comes to visitors and that people are there to emphasise the importance of hygiene.”

Last year, it was revealed the number of patients who died as a direct result of the Clostridium difficile superbug was higher at the ERI than at any other hospital in Scotland, although that has improved.