Keeping It Clean – Infection Prevention and Control in Hospitals

There are many germs that can cause infections; some of which live on our bodies and others are found in the environment. When the number of organisms evokes a response from the human host, we see signs of infection. 

In the UK some of the infections associated with healthcare received in the community and in hospitals are called MRSA and C. difficile.

MRSA, or Methicillin-Resistant Staphylococcus aureus, is a bacterium that is responsible for a number of difficult to treat infections in humans. It can happen in hospitals because patients with open wounds, invasive medical devices and weakened immune systems are at greater risk of infection than the wider population.

Healthy people can carry MRSA without showing any sign of symptoms for periods from a few weeks to many years.

Detection of MRSA is carried out by swabbing the inside of the nostrils and isolating the bacteria. The spread of MRSA can be restricted by introducing additional cleaning measures and stringent hand hygiene.

 Screening of some groups of patients admitted to hospital has been found to contribute to a reduction in MRSA infections.  

MRSA bacteraemia, which is an MRSA infection in the blood, can progress quickly within 24 to 48 hours of initial symptoms.

About 75 per cent of MRSA infections are restricted to skin and soft tissue and can usually be treated successfully with careful selection of effective antibiotics. However, in rare cases an MRSA infection can enter the bloodstream, and can affect vital organs and lead to widespread infection, toxic shock syndrome and necrotising (‘flesh-eating’) fasciitis.

Clostridium difficile (C. diff) is a spore forming bacteria that causes diarrhoea and other intestinal disease. It can takes hold when the good bacteria in the gut flora are destroyed by antibiotics.

Many babies are born with C. difficile bacteria in their gut as a protective mechanism for them as they mature, and a few continue to adulthood with C. diff occurring naturally in their gut with no sign of symptoms. Other people accidentally acquire the bacteria when they are patients in a hospital, nursing home or other facility.

It is the most serious cause of antibiotic-related diarrhoea and can lead to severe infections of the colon.

Mild cases can be cured by simply stopping the antibiotics involved. In more serious cases there are drugs available that are taken orally. Both of these situations require medical management of the patient as stopping antibiotics without good reason can lead to further problems with antibiotic resistance or a worsening of the original condition. 

The presence of any of the following signs – significant diarrhoea; recent antibiotic exposure; abdominal pain; fever; and/or foul stool odour – are recognised as indicators for the presence of C. diff.

Washing your hands regularly with water and soap and drying them well is a great way to reduce the risk of passing on many infections: this is good practice in the home as well as in the hospital setting.