A superbug's life (From Times Series)

A superbug's life

6:18pm Wednesday 21st July 2004 in Feature Focus By Tom Spender

Hospitals are there to improve your health, but as more and more patients are finding out, they can also make you seriously ill. TOM SPENDER reports

Teresah Anwell spent long periods in Barnet Hospital between 2000 and 2002.

She was admitted with diverticulitis, an intestinal inflammation, and she returned home with Methicillin-Resistant Staphylococcus Aureus (MRSA), a potentially-lethal infection also known as the hospital superbug.

"You just feel so ill. It's like your body is slipping into a pit. It's something I find difficult to talk or think about," she said from her home in The Close, Potters Bar.

Although it has yet to be proven that she picked up the infection in hospital, Teresah, 60, is in no doubt about where she was infected and why. And now she is considering suing the NHS.

"The cleaning in the wards was abysmal," she said. "I'm disabled and I can clean my toilets cleaner than they were. The sister on my ward was exasperated with the cleaners. I certainly got MRSA afterwards."

Tom Snowball, 65, of The Crescent, North Finchley, is setting up a support group for MRSA sufferers in London and the Home Counties.

He believes he got MRSA at the Heart Hospital, part of University College London Hospital in central London, when he went in for a triple heart bypass operation and said he knows of about 300 people, including Teresah, who are considering legal action after contracting the bug, which can be fatal.

"MRSA is a living death sentence and it is down to bad cleaning. I was a combat medic for 22 years and we never had one cross-infection during that time. We were told to make all the beds, do all the dusting, mop the floors and clean all the toilets and washbasins.

"The NHS should pay cleaners a decent wage and give them proper training. But they are being hampered by those above," he said.

But there is hope. Leela Biant, an orthopaedic surgeon, wiped out MRSA in the orthopaedic ward at Broomfield Hospital in Chelmsford, Essex, with a pioneering regime based on screening and strict hygiene standards. She remains critical of hospital managers.

"The surgeons at Barnet have been wanting to implement ward isolation for some time," she said. "As in other places they have come up against a bit of resistance because management feel it is not cost effective." Her comments have been backed up by staff at Barnet.

Ms Biant's ploy was simple: any patient testing positive for an infection, particularly MRSA, was treated in the community and not allowed into her ward until they tested negative.

"The year before we had 45 infections, nine were MRSA. We did 418 operations. The year after, we had 15 infections of which none were MRSA. We reduced the rate of infection by 15 per cent and stopped MRSA. And we did 17 per cent more hip and knee replacements about 488.

"Because the patients were not in hospital as long, we could safely discharge them earlier because there were fewer complications. And we knew people could come in so our bed management was more predictable," she said.

Fighting MRSA at Barnet and Chase Farm is Juliette Beal, who was appointed the trust's designated director for infection control at the end of April. Her team will number six nurses.

Last week, Barnet and Chase Farm Hospitals NHS Trust had an infection rate of 0.27 infections per 1,000 bed days.

Ms Beal denied that pressure to meet targets for waiting lists and numbers of operations was leading hospital managers to resist calls among clinical staff for more radical measures to combat MRSA such as isolating entire wards.

"It isn't the case with us. We listen very carefully to suggestions at our infection council forums," she said.

The published MRSA rates were flawed, she said, because they did not differentiate between patients who were infected with MRSA before they entered the hospital and those who were infected in hospital.

And she claimed rates of MRSA are particularly high in the population at large in north London.

"There is a high level of MRSA particularly in our population compared to other areas. It is high in north central London out to the edge of Hertfordshire. We need to understand why that is," she said.

But she denied that MRSA might have spread in north London because of poor standards of care in hospitals such as Barnet and Chase Farm.

"That's a huge jump to make. Hospitals are not the only places MRSA is disseminated. Once you get a pocket in the population it spreads quickly," she said.

To tackle MRSA, Ms Beal said the trust was now ready to introduce a 'robust' set of measures including spot checks on their current cleaning contractors Metier and screening for MRSA on patients before they enter the hospital.

"Our aim is to have reduced MRSA infection rates by this time next year," she said.

And if she doesn't the NHS may have many more litigants such as Teresah on their hands.

The first meeting of the London MRSA support group will be on August 21 at the Red Cross Centre, Houndsfield Road, Edmonton, between 2pm and 4pm.

For more information about the group, visit www.mrsasupport.co.uk or call Mr Snowball on 020 8343 7743.