Mater Dei superbug slowly retreating
The number of healthcare workers who wash their hands or use alcohol rubs before examining or treating patients is at 50 per cent, up from just nine per cent in December 2009.
The superbug MRSA that has been lurking in Mater Dei Hospital threatening to undermine its reputation is slowly retreating, according to the latest figures.
There were 28 MRSA infections in blood identified at Mater Dei this year, down from 31 cases last year and the 39 identified in 2007 at St Luke’s Hospital before migrating to Mater Dei, Infection Control Committee chairman Michael Borg said.
“I’m happy to report we are seeing a trend for the better with the number of MRSA infections at Mater Dei improving,” he said when contacted.
The decrease, although small, is encouraging and Dr Borg attributes this shift to a change in culture among doctors and nurses when it comes to scrubbing up their hand hygiene habits.
Last December, The Sunday Times had reported that just one in 10 medical staff at Mater Dei washed their hands before treating or examining patients, which exposed habits that increased the spread of potentially deadly infections.
MRSA is a type of bacteria commonly found on the skin and in the noses of healthy people. Although it is usually harmless, it may occasionally get into the body through breaks in the skin such as abrasions, cuts, wounds, surgical incisions or catheters, and cause infection.
The situation has improved drastically within one year and now some 50 per cent of healthcare workers are washing their hands or using alco hol rubs before examining or treating patients, compared with nine per cent in December 2009.
“Massive progress has been registered – the staff have been very cooperative and practices are changing for the better. We are gauging this through regular audits in the wards where we observe hand hygiene performance as well consumption levels of alcohol hand rub,” Dr Borg said.
“It will take some time until we see this good practice translate into significantly lower MRSA levels at the hospital because of all the different factors that contribute to the spread of the superbug, but we are on the right track.”
Dr Borg urged doctors and nurses to keep up this momentum: “Our aim is to reach the levels of 75 per cent, achieved at the WHO hand hygiene reference hospital in Geneva, a role model for its infection prevention systems.”
He is also appealing to GPs and the community to reduce the intake of antibiotics.
Once described as a wonder drug, antibiotics are losing the battle against superbugs such as MRSA, which are becoming increasingly resistant to the drug due to the excessive misuse and over-prescription.
E. coli, a bacterium that can cause common infections outside hospital, is another that is becoming increasingly resistant to antibiotics within the community – up to 30 per cent in 2009 from 15 per cent in 2005.
Patients needlessly took antibiotics for viral infections such as the flu (19 per cent), a sore throat (23 per cent) and a cold (12 per cent), according to a Eurobarometer study.
This same study, released earlier this year, showed Malta was the second highest antibiotic consumer in the EU with 55 per cent of the population taking at least one course of antibiotics during the year, much higher than the European average of 40 per cent.
In Scandinavian countries, less than one in four people resort to antibiotics despite the greater risk of respiratory infections from the colder climate.
The situation has improved in recent years, with only five per cent of these antibiotics being obtained without a medical prescription, marking a decrease in the problem which stood at 17 per cent 10 years ago.
“We now need to tackle the 95 per cent that are prescribed,, especially the half given unnecessarily for viral conditions,” he said.
Dr Borg maligned the prevalent “just-in-case syndrome” where antibiotics were given to prevent the infection going down to the bronchi. He said there was no evidence in the scientific literature of any benefits of treating a secondary infection when this had not yet developed.
“If you do not have fever and can continue with your normal daily routine, it is highly unlikely you have a bacterial infection – viral infections will not be cured or improved with antibiotics.”
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louis zammit
Dec 27th 2010, 12:05
my mother was one of those 39 that got this at st lukes........
my mother died few weeks after cos of a weak heart......
was she ever cured.... we will never know....
but 50 is not enough ,,,one person is enough to spread this terrible bug
may she rest in peace
f vincenti
Dec 27th 2010, 09:56
50% is not an acceptable level. Matters should be taken seriously and no excuses accepted. Anyone caught not practicing basics should be reprimanded or suspended immediately - after all healthworkers should be reminded that their health is always at stake, not just the wellbeing of the patients they work with. Florence Nightingale is probably rolling in her grave.
Dr E Barthorpe
Dec 27th 2010, 00:50
As a British doctor, I find it concerning that 50% of healthcare workers washing their hands is classed as an acceptable level. The very fundamentals of infection control lie in basic hygiene ie. handwashing. I have worked at St Luke's in Malta for a brief period and was shocked at the lack of sinks and soap dispensers. I find it incredible that in a brand new hospital, these basic facilities aren't available, surely the levels of hygiene should be much greater. Or is it that staff aren't trained in basic hand washing technique? The problem of MRSA is well known in Britain. In fact the hospital I work at had a problem with this superbug previously. However, the levels have been greatly reduced due to rigorous infection control measures and education of staff in hand washing techniques. The basic principle is to WASH YOUR HANDS both before and after examining patients. Let's get back to basic care, and your statistics and patient safety will improve dramatically.
Reuben Scicluna
Dec 28th 2010, 07:06
There is a sink in every ward - at least. There is also an alcohol scrub, a soap dispenser and printed instructions on which to use (i.e. either the soap or the alcohol), how and when.
I don't know what gave you the impression that the "basic facilities aren't available"
G.Plant
Dec 26th 2010, 21:28
A few yars ago I was on holiday in the Maltese islands and contracted salmonella. I was admitted to hospital and treated very well except that there was no soap or paper towels in the toilets. I had to ask three times for soap before any arrived. I think it was brought from someone's home because the brand was a well known store. The staff moved from me to other patients without using gel. One day when I used the toilets, a lady spoke to me and said she thought I wasn't Maltese. When I asked why she said because firstly you flushed the toilet and then you washed your hands. The consultant who treated me commented that salmonella is indemic in the islands but he didn't know why. I think I do.
Randolph Spiteri
Dec 27th 2010, 01:59
I don't think it was just some years ago,but hundred years ago. Just have a look how our hospitals are classified by the WHO and you will get an answer for your treatment you received a 100 years ago
Reuben Scicluna
Dec 28th 2010, 07:11
Salmonella is not "indemic" (I think you meant endemic) to Malta. I'm sure you'd come across it in your country.
Marthese Mussett
Dec 26th 2010, 17:04
You are so right.I am always reminding my children to wash their hands after using the toilet etc..When I was still a teenager I was in a bar once,went to the toilet,and saw the bartender go in the toilet,then out,without washing her hands,then she carried on working behind the bar,serving drinks and touching the rims of glasses.This is still happening.You don t need to be a genius to know that washing your hands often is a vey good thing.Even when you go home after work or a day out.the first thing to do is to wash your hands very well.
C Cassar
Dec 26th 2010, 14:30
Finally some Maltese are rembering to wash their hands regularly. A shame this habit is lost on many restaurant staff who regularly pick up food with bare hands and serve it after having gone to the lavatory or patted their friends dog who has just arrived. The word 'hygiene' seems to be missing from the vocabulary of many Maltese.
John Williams
Dec 26th 2010, 15:20
How very right you are C Cassar when I pointed out the need of hygene by hospital staff I was told that by a very rude nurse that MRSA was brought to Malta by British patients
http://www.mrsa.uk.com/docs/Hospitals.htm
Mikiel Sciberras
Dec 26th 2010, 18:25
@John Williams
The nurse was not rude but was just telling the truth. MRSA is not an ordinary bacteria, but one that became resistant to common antibiotics. It comes in two versions, community acquired and hospital MRSA. I remeber circa 1995 when I worked in a hospital in Malta we were always on the look-out and dreading receiving a patient from the UK who might be already exposed and harbouring the germ - but despite our precautions, it eventually appeared in our hospitals too. This is not to say that the UK is to blame but the overuse of a antibiotics had rendered the bacteria immune to these therapies and MRSA spread all over the world.
In addition to overprescribed antibiotic use for colds, there was the extensive and excessive use of antibiotics on factory-farms, where animals were kept in restricted and unhygienic quarters and pumped full of antibiotics before going to market. Some authorities blame the latter for the emergence of drug resistant bacteria, so ultimately MRSA is a human creation, brought about by overuse of antibiotics that are necessary to feed the exploding human population with factory-farmed animals.
charmaine magro
Dec 26th 2010, 14:10
And are patients who are going to undergo surgery being informed that they could get the MRSA, in which case there stay in hospital will be soooo much longer than anticipated? Like what happened to my dad years back , when a simple op turned out into a three month stay?? Shame if you are not telling them!!
S. Zammit
Dec 26th 2010, 15:48
As far as I know the chances of being infected with MRSA are extremely slim. In such a situation you have to appreciate the fact that if you had to list every single possible minute detail which could go wrong (lists may be endless), too many patients would turn away from surgery.
A Cassar
Dec 26th 2010, 16:29
Charmaine.....all persons undergoing surgery should have all the risks explained to them before they consent to surgery. If the risks are not explained to you, then you should ask before signing the consent
robert micallef
Dec 26th 2010, 14:09
in Scandinavia also children get sick much less then ours, one of the reasons is thought to be from the use of saunas. i used to get sick and be given antibiotics by the doctor nearly twice a month in winter. then i read how beneficial vit C is and now whenever i feel like im getting sick i start taking this vitamen. in around 20 years i only took antibiotics twice. you can read "beyond antibiotics" but i dont know if its still in print. i am quite surprised when people have a sore throat they just take a couple of antibiotics just for 1 or 2 days, i'm even more surprised that they are still able to buy them without a prescription.
Jan Sammut
Dec 26th 2010, 12:46
Antibiotic consumption will only decrease once doctors stop being paid commissions on a per prescription basis.
J. Debono
Dec 26th 2010, 12:59
You very well know Jan, that your statement is false.
If however, you have proof, just give it to the media, or the concerned bodies, whatever you choose!, and I will be the first to excuse myself.
Joshua Abela
Dec 26th 2010, 14:03
Can you prove your point? If you don't have any evidence to back your claim, I suggest you keep your mouth shut.
A Cassar
Dec 26th 2010, 16:27
That is a COMPLETELY FALSE statement.
Kindly report to the medical council any doctor who receives commissions on prescriptions and he will be struck off the register!!!
a. galea
Dec 26th 2010, 16:31
They are not given money but yes gifts are given to doctors prescribing antibiotics. Dinners is the norm but other gifts have been given specifically to certain docs that prescribe a large number of antibiotics. Once pharmacists hand in the prescription form to the department data is taken to see which doc gave what. That's why some doctors give the tradename and not the generic name of antibiotics so you purchase from a particular agent
A. Agius
Dec 26th 2010, 17:32
Mr/Ms A. Galea - can you please specify which exact "department" are antibiotic prescriptions handed into? Because for a fact all prescriptions are given back to the patient - this is the law and I can assure you there is no hidden database of doctors and which antibiotics they prescribe. These conspiracy theorists should lay off watching sci fi teleseries! A student pharmacist I know wanted to do her undergraduate thesis on antibiotics and the lack of statistics available is shocking. As for the "dinners" that are paid these are part of the regular continuous medical education lectures that companies support in the absence of any sort of national programme paid for by the Ministry of Health. That is not to say that there is no influence on doctors by the representatives of drug companies - if they did not increase sales they would not employ them. However it is ultimately up to the doctor and his/her integrity. If a few samples or the sponsoring of a trip to a medical conference abroad is enough to make him prescribe antibiotics unnecessary and cause harm to the patient and the community, then that is not a professional and ethical physician.
DGalea
Dec 27th 2010, 00:51
I assume that you have proof to support your assertions.
pCassar
Dec 27th 2010, 04:22
This goes as well to the ammount of sick leave certificates issued even just over a phone call by doctors to their patients. This regularly happens especially with goverment employees because there is no body that checks this out.
msammut
Dec 26th 2010, 12:22
not to say anything of residual antibiotics in the meat we eat...