Thursday 23 November 2017

Basic hygiene can banish the superbugs from hospitals

Hand hygiene can help prevent the spread of the winter vomiting bug
Hand hygiene can help prevent the spread of the winter vomiting bug

How effective are MRSA superbug prevention and control strategies in our hospitals? The jury is still out according to a review in the medical journal, The Lancet.

The authors reported that there is particularly weak evidence about the effectiveness of screening and isolating infected patients - practices which have long been regarded as the gold standard in MRSA prevention strategy and are required by law in some countries.

And one Swiss expert concluded that traditional infection control measures may be the most effective against MRSA.

After reviewing studies on MRSA strategies in hospitals over the past decade, the authors argue that although various approaches to tackle MRSA have been examined, most of the research has looked at bundles of control measures, rather than assessing each measure in isolation.

This means we don't yet know which individual components work best, or whether some prevention strategies may even be pointless in the battle against superbug hospital infections.

Professor Gerd Fatkenheuer, study co-author, said: "In the haste to do something against the rising tide of MRSA infection, measures were adopted that seemed plausible.

"But these were not properly assessed, and bundled the effective and harmless with the ineffective and harmful.

"We know, for example, that isolating patients can result in anxiety and depression and fewer visits by doctors and nurses," he added.

"We need better studies," said Professor Bernard Hirschel, former chief of the HIV unit at the Geneva University Hospitals in Switzerland.

"With the tide of MRSA receding and improved treatment options for the infection, a window of opportunity now exists to reassess whether masks, gowns, gloves and single rooms add anything to the traditional infection control measures of hand hygiene and universal decolonisation (a daily bath with an antibacterial agent) which have proved much more successful in reducing rates of MRSA."

According to The Lancet report's co-author, Prof Stephen Harbarth from Geneva University Hospitals in Switzerland, "the lack of effectiveness of active detection and isolation should prompt hospitals to favour evidence-based measures adapted to local conditions and settings, which weigh up effectiveness, costs, and adverse events.

"Recommendations should state the uncertainties in this field, and legal mandates on specific control measures for MRSA should be abandoned."

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