Hiqa wants action to combat superbugs threat

The State’s health services watchdog says more needs to be done to protect patients from the growing superbug threat.

The Health Information and Quality Authority (Hiqa) found that a number of hospitals need “urgent support” from the HSE in addressing antimicrobial resistance.

Hiqa’s acting head of healthcare regulation, Sean Egan, said the hospitals do not have an antimicrobial stewardship programme in place and lack specialised resources.

“This is a significant patient concern and should be reviewed as a matter of urgency by the HSE,” said Mr Egan.

A Hiqa report points out the national plan to deal with the problems has not been updated since 2001, with a new one urgently needed.

Millions of lives have been saved or improved since the discovery of penicillin and other antimicrobial medicines.

However, resistance to antimicrobials has begun to outpace the discovery of new drugs, and more highly resistant infections are emerging.

Hiqa examined how public acute hospitals were dealing with the threat, and, while progress had been made, it varies across the country.

In particular, it found that some of the smaller hospitals do not have “safe and sustainable” measures in place to protect patients.

“More needs to be done to ensure that good practice in this area becomes the routine norm,” said Mr Egan.

On any given day in Irish hospitals, about one in three patients receive antimicrobial medicines to treat or prevent bacterial, viral, or fungal infection.

Methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile rates have fallen in Ireland, but the incidence of multi-drug resistance among another bacteria group is increasing.

Mr Egan said Gram-negative bacteria are highly resistant and are associated with severe infections, up to and including life-threatening sepsis and, unlike MRSA, patients who carry these bacteria can not be treated to eradicate them from their bodies.

“Antimicrobial prescribing and infection control practices in hospitals and, equally, in community health and social care settings need to be of a high standard to fully address this emerging problem,” said Mr Egan.

He said there are “pockets of excellence” in some hospitals, but others lag behind, while progress in non-acute settings, such as nursing homes, has been limited.

The Hiqa review began in June last year but the report, published yesterday, does not identify the hospitals where significant shortcomings were found.

There was confusion at the start of the review as to the person in the HSE who held overall responsibility for infection prevention and control and antimicrobial stewardship — the prudent and safe use of antibiotics.

The HSE later clarified to Hiqa that the national director for health and wellbeing holds overall governance responsibility in the area.

The HSE said it will “actively address” opportunities for improvement identified by Hiqa.


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