'Hospitals lack key MRSA personnel'

ALMOST half of Irish hospitals are without key personnel central to the detection of the potentially fatal MRSA superbug.

In addition, around 10 hospitals have no infection control nurses, according to Dr Robert Cunney, consultant microbiologist with the Health Protection Surveillance Centre.

Contrary to the general public's perception, Dr Cunney also said physical hygiene in hospitals is "not a major factor" in the spread of the superbug - but "if a hospital is clean, it usually indicates other things are going well".

Dr Cunney was speaking yesterday at a meeting of the Oireachtas Health Committee to discuss MRSA. He said that while smaller hospitals didn't necessarily need a consultant microbiologist on site for the detection of MRSA because of low risk to patients, Ireland was "starting at a very low base in terms of personnel".

"Our first priority with funding must be getting these people on the ground," he said.

Dr Mary Hynes, assistant national director of the Health Service Executive's National Hospitals Office (NHO), said the issue of GP prescribing had far greater bearing on the rate of MRSA infection in hospitals and the community.

Dr Kevin Kelleher, assistant national director of the HSE's Population Health Directorate, said antibiotic use was "a major behavioural issue", which had to be tackled.

"People take their child into the GP with an earache or a throat infection and it takes the GP 15 minutes to persuade them they don't need it compared to one minute to write a script. One of the key messages to come out of the meeting today is this is fundamentally about antibiotic prescribing. We need to be very careful about how we use them in the future or we could lose a very powerful drug," he warned.

Dr Cunney said the use of a clinical pharmacist to monitor prescriptions had proved effective in the Midlands area of the HSE and prescription rates had dropped.

Chairman of the Oireachtas Health Committee, John Moloney, asked who was going to be responsible for monitoring MRSA in hospital wards and who would be held accountable if infection spread. Dr Kelleher said responsibility would rest with hospital network managers, hospital managers/CEOs and managers of local health areas.

Experts attending the committee agreed patients had a right to be told if they had MRSA.

Senator Browne said he knew of a situation where a woman found out she had MRSA when one contract cleaner in a hospital ward yelled to another: "That lady has an infectious disease. Don't use a mop in that area."

There was criticism from members of the committee that while a national figure for MRSA bloodstream infections is available (316 for the first six months of 2005), individual hospitals do not generally have figures. Dr Kelleher said they hoped to introduce a standardised system for collecting MRSA data over the next year.