Hospital MRSA infections fall as others raise concerns

WHILE the rate of hospital-acquired MRSA infections has fallen in Ireland, there is concern at the increase in other bacterial infections that can be resistant to antibiotics, a medical expert warned.

Consultant microbiologist with the Health Protection Surveillance Centre, Dr Rob Cunney, said there has been an increase to meticillin-sensitive S Aaureus (MSSA) infections and no one understood the reason for this.

There are now several variants of MSSA that are also resistant to antibiotics.

The rate of MRSA infections fell from around 42% in 2006 to 27% in 2009.

Dr Cunney, who was speaking at the launch of a report, MRSA in Ireland: Addressing the Issues, said MSSA infection rates had been increasing, particularly since the end of 2008.

They did not know why this was happening but it was important to note that while there had been a decrease in one bacterium, another was taking its place.

“There may be some strain replacement going on,” he warned.

He pointed out patients with MRSA infections were more likely to die than those with MSSA infections.

“About 30% of MRSA patients died compared with about 14% with MSSA – about a twofold difference,” he said.

While there was a reduced risk of death associated with MSSA, it was still significant, he pointed out.

Dr Cunney said it was not fully understood why MRSA rates were falling but it was probably a combination of factors.

Cases were being detected more quickly; there was more targeted screening and isolating patients with MRSA. There had also been a doubling of the use of hand gels in the last five years.

Antibiotic prescribing had gone down largely in hospitals with microbiologists and pharmacists that had set up antibiotic stewardship teams.

Patient advocate Stephen McMahon said increased public attention about MRSA infection had resulted in a number of key guidelines and measures being introduced that might be having some beneficial effect.

President of the Irish Society of Clinical Microbiologists, Dr Niamh O’Sullivan, who also spoke at the launch of the report, funded by Pfizer, said a barrier to keeping infection rates down was insufficient hospital isolation rooms.

Also, spending on hospital cleaning had been “cut to the bone” so there was little time available to spend on cleaning an area properly.

The report, launched at the Royal College of Physicians in Dublin was developed by a multidisciplinary advisory group including microbiologists, hospital pharmacists and patient advocates.