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Healthcare associated infections
MRSA, C-difficile and GRE
Perhaps the most commonly known infections which are associated with healthcare are MRSA (Methicillin Resistant Staphylococcus Aureus), C difficile (Clostridium difficile) and GRE (Glycopeptide Resistant Enterococci), although these are only some of the infections which can be transmitted in a hospital situation.
Potentially preventable in most cases, it is essential in a hospital setting that the use of alcohol gel is enforced, since the most common form of transmission is through physical contact.
Conditions such as pneumonia and procedures such as catheterisation can lead to infection and surgical site infections, blood stream infections are also common sources of these types of infections.
For more information on healthcare associated infections, and how Clear Answers may be able to help you, please select one of the links below
- Methicillin Resistant Staphylococcus Aureus
- Contraction and transmission of MRSA
- Preventing MRSA
- Clostridium difficile
- Contraction and transmission of C-difficile
- Prevention of C-difficile
- Glycopeptide Resistant Enterococci
- Contraction and transmission of GRE
- Preventing GRE
- Medical negligence news stories
- Medical negligence compensation claim advice
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Methicillin Resistant Staphylococcus Aureus
Commonly known as MRSA, Methicillin Resistant Staphylococcus Aureus is a multi drug resistant organism and is the most commonly known infection acquired through healthcare treatment.
If MRSA enters the body or the bloodstream through a break in the skin, infections can start to develop. However, since the organism can be carried on the surface of the skin and in noses (known as being colonised with the organism) without harm and without the disease developing. the regime of using alcohol gel is vital to ensure that the organism is not passed from one person to another person who may have be more susceptible to developing the disease, through the presence of cuts, surgical sites, or open wounds.
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Contraction and transmission of MRSA
Since MRSA needs to enter the body or bloodstream to cause infection, it is logical that a hospital setting would provide the most opportunity for the organism to find conditions for infection.
Patients who have undergone surgery or have open wounds, cuts or burns will be most at risk. Also at a higher risk are those patients who are, or have recently been on anti-biotics, as are patients such as babies and cancer patients who have a weakened immune system.
However, anyone is capable of developing the disease if infected, and colonised individuals can pass the organism into the environment around them at any time. For example the transmission through the hands-on care which is provided by healthcare assistance during the treatment of their patients.
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Preventing MRSA
Since the passing of the Code of Practice in the Health and Social Care Act (which was originally published in 2006 and updated in 2008), it has been mandatory for all UK Hospital Trusts to have an MRSA protocol in place aimed at reducing the incidence of transmission and infection. The Act sets out the national guidelines for the National Mandatory Surveillance Programme, to which all hospitals must adhere.
To meet these guidelines, many hospitals have adopted the practice of screening patients before elective surgery. This involves taking swabs from the nose of the patient, although to increase the sensitivity of the test, a full screen can be taken, which includes swabbing from the throat, axilla, groin and perineum.
Further screening of staff has not been recommended since, due to the sometimes transient nature of colonisation, it is possible for a person to be MRSA positive in the morning and negative in the evening. It has therefore been considered non-cost effective to remove staff from their working environment.
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Clostridium difficile
Clostridium difficile, or C-difficile as it is more commonly known, is an anaerobic bacterium that does not require oxygen and is therefore capable of surviving in an environment for a long time.
Although it can also lead to ulceration and bleeding from the colon, known as colitis, C difficile is more commonly known to cause mild to severe diarrhoea. Capable of being diagnosed through analysis of a fecal sample of the suspected carrier, in the worst case, C difficile can lead to peritonitis, which itself can prove to be fatal.
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Contraction and transmission of C-difficile
Whilst anyone is capable of contracting C-difficile, patients who are, or have recently been, on a range of anti-biotics are at a higher risk of contracting the infection. Also, elderly patients and those with a serious or severe underlying illness are most at risk.
Although it is possible to contract C difficile anywhere, again it is most commonly found in medical establishments such as hospitals and medical care centres, with Nursing homes posing the most serious risk of infection overall.
Cross-contamination in a hospital setting usually results either from direct patient-patient contact, or through hospital staff, though the infection can occur through touching contaminated objects themselves. The organism is passed by spores in the faeces of diarrhoea from a person carrying the disease.
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Prevention of C-difficile
The Department of Heath issued guidelines dated the 8tH February 2007 highlighting three essential principles in managing C-difficile. These essential principles are:
- Anti-biotics should be prescribed prudently, to reduce the use of broad spectrum anti-biotics. This in turn should reduce the number of people at a high risk of contracting the infection.
- Isolation of patients with C-difficile in a medical care setting.
- Enhanced environmental cleaning, particularly given the potential long life of the infection. The Department of Health have emphasised the importance of the use of chlorine disinfectant, and the importance of regular hand washing. The use of aprons and gloves are also encouraged, especially when handling faeces and bed pans.
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Glycopeptide Resistant Enterococci
Glycopeptide Resistant Enterococci (more commonly known as GRE) are enterococci bacteria that are resistant to glycopeptide antibiotics. Found in most human bowels, there are many different species of enterococci bacteria, but the majority of infections are caused by either Enterococcus faecium or Enterococcus faecalis.
Well known for causing wound infections, blood poisoning and urinary tract infections, GRE can additionally cause infections of the bile duct, abdomen, pelvis and the heart valves (endocarditis).
GRE usually only causes infections in people who are already rather unwell, unlike MRSA, which can occur widely in healthy patients. The majority of anti-biotics are ineffective, though it can be treated through the use of Linezoid and Synercid and it is capable of being diagnosed through analysis of a fecal sample of the suspected carrier.
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Contraction and transmission of GRE
There are two ways in which GRE can be contracted. Firstly through cross-contamination, usually in a hospital setting through patient-patient contact, touching contaminated objects themselves, or through the treatment delivered by hospital staff.
The second source of infection can be from the enterococci bacteria already present in the patient, which often resides harmlessly in the bowel. If the organism moves from the bowel to other areas of the body where it is not normally found, an infection develops which cannot be prevented by a healthcare provider.
Anyone is capable of contracting GRE by either of these methods, though patients most at risk are those whose immune system is compromised, or who have had a prolonged hospital stay. And particularly at risk are those patients in intensive care and renal units.
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Preventing GRE
The Health Protection Agency has provided guidelines highlighting an essential principle in managing GRE, although further research is currently underway with the Department of Health to monitor and combat GRE.
Current findings show that enhanced environmental cleaning, particularly the importance of washing hands before and after visiting patients, can help prevent the spread of infection from GRE.
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Medical negligence news stories
Below is just one example of a news story related to healthcare, which we hope you will find of interest.
Please also visit our regularly updated Personal Injury News Section to view some examples of our successful personal injury accident compensation claims, and other news items.
Care Quality Commission report on NHS Trusts
“One in eight NHS trusts has been told it must urgently improve the care it provides.” That’s the headline published in October 2009 by the BBC News Channel.
The assessment by the Care Quality Commission (CQC) showed that more services than ever could be rated good or excellent.
One area highlighted by the CQC as a success, is the rate of infections of hospital-acquired diseases such as Clostridium difficile and MRSA. Both rates had fallen by about a third, despite the hospitals themselves reporting failings in areas of hygiene.
More about Care Quality Commission report on NHS Trusts
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Medical negligence compensation claim advice
If you or your family have contracted MRSA or another healthcare related infection, please contact us to day for advice about whether we can assist you with a medical negligence compensation claim. Please call 0800 783 9019 or complete one of our online compensation claim forms. One of our representatives will contact you (without obligation) as soon as possible.
Win or lose, there is nothing to pay in order for us to pursue a valid personal injury compensation claim. There are some exceptions to this in Medical Negligence cases. Please go to our Costs and Risks section for more detailed information on these and how Clear Answers will handle your claim and funding.
Strict time limits apply for making a personal injury compensation claim, so please seek expert legal advice as soon as you think you may have a valid claim for compensation.
Please visit our section on information and advice for more details on making a personal injury compensation claim.
Alternative funding arrangements may apply in Northern Ireland due to differing procedures and Law Society regulations
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