Superbug kills 12 at spinal unit as doctors warn of new threat to NHS
By Jeremy Laurance, Health Editor
06 June 2005
An outbreak of a lethal new bug at a leading specialist hospital has
claimed 12 lives and is posing a grave new threat to the NHS, doctors
have warned.
More than 300 patients have been infected with the bug, a virulent new
strain of Clostridium difficile, at Stoke Mandeville hospital in
Oxfordshire, known for its world-famous spinal injuries unit supported
by the former disc jockey Sir Jimmy Savile. But all attempts to
control the infection, which causes severe diarrhoea that can be
life-threatening, have failed.
The disclosure raises new concerns about NHS hygiene following a
series of scares over the superbug MRSA and the pressure on hospitals
to hit waiting list targets.
Cases of C. difficile have soared from fewer than 1,000 in 1990 to
43,672 in 2004 but it has not received the same attention as MRSA.
Latest figures show there were 934 deaths in 2003, a 38 per cent rise
in two years. A similar number of people died from MRSA in the same
year, with 955 people dying from the infection, a 30 per cent increase
in two years.
The bug poses a particular threat to hospitals because it produces
hardy spores that are resistant to normal methods of cleaning and can
persist on hands, clothes, bedding and furniture, transmitting the
infection to new patients.
Alcohol gels used by medical staff to clean their hands between
patients, in an attempt to combat MRSA, are ineffective against the
spores of C. difficile. The Health Protection Agency (HPA) said
washing in soap and water was necessary to eliminate the bug and
powerful disinfectants were needed instead of ordinary detergents to
clean the wards.
Fears about the growing threat posed by the bug led the Department of
Health to introduce mandatory reporting of infections caused by the
bacterium last year. The cost of treating each case was estimated at
£4,000 in 1996, implying a cost to the NHS today of more than £200m.
A report by the National C. difficile Standards Group set up by the
health department in 2003 said the rise in cases was "dramatic" and it
had happened "at a time when there is a general perception that
standards of hospital cleaning have been declining".
Andrew Berrington, consultant microbiologist at Sunderland City
hospital and a member of the standards group said: "It is a serious
problem and in some ways more serious than MRSA. A new strain would be
an important and concerning thing. "
The outbreak at Stoke Mandeville, which started in 2003, is caused by
a more virulent strain of the bacterium closely related to a type
found in the US and Canada, which is more infectious and harder to
destroy. Stoke Mandeville is the only hospital in Britain where large
numbers of cases of the new strain have been recorded. The hospital
treats patients with severe spinal problems who may remain there for
months, putting them at high risk from hospital infections.
Doctors at the hospital blamed managers' "obsession" with hitting
government waiting list targets for the failure to eradicate the bug,
and claimed HPA advice had been ignored. In a statement,
Buckinghamshire Hospitals NHS Trust said 225,000 people had been seen
at the hospital in the last 18 months and everything possible was
being done to contain the outbreak. The average age of the patients
who died was 85, although it is understood some younger patients have
been affected. The number of infections peaked, then fell and then
peaked a second time.
Dr Andrew Kirk, director of Infection Prevention and Control, said:
"Infection control is one of the top priorities for this trust. We are
adopting the most up-to-date technology to ensure that we minimise any
risk of patients acquiring infection while in hospital. We do however
need to be realistic about the prevalence of these bacteria in our
community and ensure that patients who acquire it are treated
effectively and quickly to prevent any further spread."
A spokeswoman for the HPA said the pressures on the hospital had
hindered its capacity to deal with the outbreak. "We have met with
them quite a lot of times and we have gone into a lot of detail about
the measures they should take," she said. "We wanted them to keep all
the infected patients in one ward but that meant they could be left
with empty beds. They didn't want to turn patients away and they have
had difficulty obtaining sufficient staff to implement all the
measures immediately."
She added: "It is taking a long time [to get it under control]. I
believe the hospital is doing better now and moving to our preferred
arrangement of keeping all infected patients in one ward. It is a
virulent strain and it is hard to crack once you have got it."
A spokesman for the health department said: "The large majority of
cases of C. difficile diarrhoea make a full recovery, however some
patients may have a more severe course that in a small percentage of
cases can be life-threatening."
"The HPA has received some reports of this new strain and is keeping a
watching brief on this but the available information indicates that
this new strain is rare in the UK. New toxin-producing strains of C.
difficile have occurred before and are not a new phenomenon. Our
guidance says nurses should wash their hands in soap and water."
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| Title: Re: Superbug kills 12 at spinal unit |
06 Jun 2005 04:29:46 PM |
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Anything that peaks twice clearly
poses a severe threat and must
be addressed at once.
Simon P. McFarlyn
President & CEO
National Sturgion Alliance
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