Patients who enter Mater Dei Hospital already colonised with the resistant MRSA bacteria are the biggest obstacle hindering the hospital’s progress in eradicating the superbug, the Infection Control Unit believes.

Unit consultant Michael Borg referred to recent research showing that between five and 10 per cent of healthy Maltese within the community are MRSA carriers, even if they never had contact with hospitals.

Dr Borg was reacting to Thursday’s presentation of the EU’s Centre for Disease Prevention and Control showing Malta is among four member states with the highest incidence of the hospital superbug, singling out the island as one “of the most worrying”.

The rate of MRSA found in blood samples (which is what the ECDC data is based on) actually improved last year with 31 cases registered at Mater Dei, three less cases than in 2009.

Dr Borg believes the improvement is even more relevant because, last year, a considerable number of blood samples were taken. The more samples you take, the more cases of MRSA you expect to find.

“However, our MRSA rates in 2008 were three times the European average, so, clearly, there is the need for substantial improvement to even get close to European levels,” Dr Borg said when contacted.

Among the recommendations of the ECDC on fighting the bug is to strengthen infection prevention and control in hospitals and clinics. Dr Borg agreed that despite the challenges Malta faced, there was still a lot that could be done.

MRSA prevention in hospitals has three major requirements: the first is to provide an environment conducive to good practice – overcrowding and understaffing are well recognised drivers of health care-associated infections and the more these are brought under control, the lower infection rates will be. The second is judicious antibiotic use. Just like in the community, unnecessary antibiotic use with wide spectrum products is a major driver for resistance.

The third is better infection control, especially in environmental cleanliness and hand hygiene by health care professionals, as well as the correct management of infusion lines and catheters.

“All these areas are being addressed as part of our efforts. Improvements have already been registered, especially in terms of hand hygiene but there is clearly a lot more we need to do to emulate our northern European coll-eagues,” he added.

Dr Borg is confident the awareness campaigns to eradicate unnecessary antibiotic use are reaping results, “We have indeed made the first steps in the right direction,” he said.

This can be witnessed in over-the-counter dispensing of antibiotics, which has dropped from about 13 per cent in 2001 to four per cent last year, which is close to the European average.The next step is to improve prescribed use. To address this, the National Antibiotic Committee has prepared guidelines which were yesterday – European Antibiotic Awareness Day – handed to all doctors and pharmacists for consultation before they are finalised.

“This and other educational measures are the only way we can approach this matter.”

The Times of London recently reported that patients faced an “impending crisis” caused by the resurgence of life-threatening superbugs unless new antibiotics were developed as a matter of urgency.

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