Three times as deadly as MRSA - and new superbug is on the rise

Key quote

"I am also absolutely convinced that we don't have enough facilities to isolate infected patients in Scottish hospitals. They need to invest the money now to save money in the future with these kind of things" - HUGH PENNINGTON, ABERDEEN UNIVERSITY

Story in full RECORDED cases of a deadly superbug that kills three times as many people as MRSA are rising in Scottish hospitals, The Scotsman can reveal.

Clostridium difficile (C difficile), which causes severe diarrhoea and mainly affects the over-65s, is rapidly becoming as common as MRSA in the battle against hospital infections.

In 2005 more than 4,400 cases were detected in Scottish hospitals, up from 4,021 in 2004 and 3,119 in 2003.

New data obtained by The Scotsman shows the number of cases in 2006 has continued to rise, with some health boards recording increases of more than 20 per cent.

The statistics come after a coroner in England warned of "huge problems" in the NHS, with the bug linked to nine deaths within a month at two Nottinghamshire hospitals.

Health officials believe a particularly virulent strain - known as 027 - could become more common in Scotland as it spreads from England.

Scotland has so far only seen one case of 027, diagnosed in October, but with rising numbers of C difficile cases being reported by health boards, many expect this figure to increase.

It is thought that around 100 deaths in Scotland in 2005 were linked to the bug.

The Scotsman's research suggests that cases of C difficile in 2006 will significantly exceed those in the previous year.

By the end of October, some boards were already reporting higher or similar levels compared with the whole of 2005.

Up to 21 October, NHS Grampian had recorded 382 cases of C difficile, compared with 324 in the whole of 2005 - a rise of 18 per cent.

And NHS Tayside had seen 349 cases to the end of October, compared with 284 in 2005 - up 23 per cent.

NHS boards said increased testing was part of the reason for rising figures. The numbers are set to rise further after mandatory reporting started in September.

The first results from that reporting are expected later in 2007.

Professor Hugh Pennington, the leading microbiologist from Aberdeen University, said that to combat the superbug, hygiene and infection measures in hospitals needed to be improved.

"I am also absolutely convinced that we don't have enough facilities to isolate infected patients in Scottish hospitals. They need to invest the money now to save money in the future with these kind of things," he said.

Shona Robison, SNP health spokeswoman, said hospitals needed to do more pre-admission screening for C difficile.

"It is vital that more screening is done, certainly for elective surgery and among high-risk groups such as those admitted from care homes," she said.

There are now plans to set up a reference lab in Scotland to test for new strains of the bug.

John Cowden, public-health consultant at Health Protection Scotland , said the 027 strain was a key concern. "This virulent strain has been seen in the US and other parts of the UK. It would be surprising if we did not see the same thing happening in Scotland."

A Scottish Executive spokeswoman said: "There has been an increase in incidence of C difficile in recent years but there has also been an increased awareness among professionals, and surveillance of this infection is now mandatory."

MRSA

METHICILLIN-Resistant Staphylococcus Aureus (MRSA) has become the best- known superbug in the UK.

• It is a specific strain of the staphylococcus aureus bacterium that has developed antibiotic resistance to all penicillins.

• It was first discovered in the UK in 1961 and is now widespread in hospitals.

• Staphylococcus bacteria are extremely common in the environment and are usually not a problem to healthy individuals.

• More than 1,000 deaths a year in the UK are officially linked to MRSA, but campaigners believe the real total to be much higher.

PVL

A PARTICULARLY deadly strain of MRSA known as Panton-Valentine leukocidin (PVL) is concerning health experts.

• PVL MRSA can cause pneumonia, as well as the flesh-eating condition necrotizing fasciitis.

• It is usually acquired in the community, but last year it emerged that two people died in a Staffordshire hospital after catching PVL.

• Figures in Scotland show community-acquired cases of PVL increased from 28 in 2003, to 62 in 2004 and 78 last year.

• Since 2003, only five PVL cases have led to the more serious bloodstream infections, with no deaths.

C DIFFICILE

Is a bacterium from the family Clostridium.

• Its usual habitat is the large intestine, and small numbers can be seen in less than 5 per cent of the healthy adult population.

• Those who are most at risk of becoming ill are elderly patients being treated with broad-spectrum antibiotics.

• Poor hospital hygiene and inappropriate use of antibiotics have been linked to rising cases of the bug.

• C difficile infection can cause severe diarrhoea and colitis - bleeding from the colon. In the most serious cases, it can be fatal.

INFECTION DETERS CANCER PATIENT FROM PREVENTIVE SURGERY

AFTER starting treatment for breast cancer in 2005, Pat Thomson thought she was on the road to recovery.

But a year later, she was diagnosed with C difficile after returning to hospital when an abscess developed near her surgical wound. After seven days in Ninewells Hospital, Dundee, she went home but soon felt unwell.

"I started going downhill. I was sick, I had diarrhoea and I couldn't eat or drink anything," she said. "I just thought it was down to the abscess."

Mrs Thomson, 65, from Arbroath, saw her GP, who said she should go back into hospital, but she wanted to stay at home. She returned to have tests done. "They told me I had C difficile," she said. "I did not know anything about it, but my daughter heard about it on the TV and said, 'That's what you had, Mum'."

Mrs Thomson was told the infection could have been brought on by antibiotics she was given when she had the abscess drained. But she was given little other information. She spent six weeks recovering at home, taking antibiotics.

"I didn't realise it was quite a severe infection," she said. "If they had said MRSA, I would have known about that, but I did not know anything about C difficile.

"I just thought it was something to do with the abscess. I would have liked more information. I just thought it was something lots of people got."

She is now contemplating whether to return to hospital to have her remaining breast removed to reduce the risk of another tumour developing.

However, she said her past experience might put her off. "It does make me more nervous," she said.