MRSA and clostridium difficile

Staphylococcus aureus is a common bacterium often found on the skin and in the nose of healthy people. This is called ‘colonisation’ or ‘carriage’.  Some strains of Staphylococcus aureus are resistant to certain antibiotics, particularly meticillin and are known as MRSA (Meticillicin Resistant Staphylococcus Aureus).

The majority of people who are ‘colonised’ with MRSA will never get an infection.  Problems only begin to occur if MRSA gets into the body through cuts or wounds, or into a part of the body that is normally sterile, such as the bladder.

For those people who are vulnerable because they are already unwell or have injuries or surgical wounds, the risk of developing an infection is higher. This is why MRSA is taken seriously when people come into hospital.

We have a comprehensive screening programme in place to help identify those people who are already colonised.  Once identified, the MRSA can be easily treated with an antiseptic wash and nasal ointments as well as antibiotics.  This removes the MRSA, and thus reduces the risk of an infection developing while receiving treatment in hospital.

Organisms such as MRSA usually spread from person to person by direct contact.  The easiest way to stop the spread is by practising good hand hygiene.  We encourage our patients and visitors to wash their hands regularly, particularly after going to the toilet or before eating food.  Visitors should also make full use of the gel provided at the entrances to wards.

Due to the nature of their work, good hand hygiene for hospital staff is of prime importance to minimise infection.  Hand hygiene standards are monitored regularly and we actively encourage our patients and visitors to ask staff if they have cleaned their hands.

Clostridium difficile

Clostridium difficile (C. diff) is a bacteria sometimes found in the gut of healthy people.  When C. diff is present in the gut along with other ‘normal bacteria’ it will not cause any harm. Sometimes, however, the normal balance of the gut can be upset, for example when taking antibiotics.

This allows the C. diff to multiply in large numbers, releasing toxins into the body.  These toxins irritate the lining of the bowel and can cause a range of symptoms such as diarrhoea, abdominal cramps, loss of appetite, fever and nausea.

When C. diff causes diarrhoea, spores are released which contaminate the surrounding environment.  These spores can live on surfaces for a long time, and are easily picked up on other people’s hands.  Through hand to mouth contact, the C. diff can then be transferred to the stomach and bowel.

We treat patients with C. diff in a side room and we carry out extra cleaning to kill the C. diff spores. Patients will be allocated their own toilet or commode and staff will wear gloves and aprons when undertaking certain procedures.

It is not necessary for visitors to wear gloves and aprons unless assisting with personal care. However, it is essential that visitors gel their hands on entering a ward, and wash their hands with soap and water when leaving.

Treatment of C. diff depends on how severe the diarrhoea is.  Sometimes no treatment is needed, and the symptoms resolve of their own accord, particularly if the patients have completed the course of antibiotics and balance of the normal gut flora is restored. Any antibiotics that are being taken will be stopped where possible, and we may prescribe a specific antibiotic which is effective in the treatment of C. diff.

Most people with C. diff make a full recovery.

MRSA/Clostridium difficile incidents

We take all possible action to reduce the incidents of MRSA and clostridium difficile and recognise that patients and their carers can become very concerned about healthcare associated infections such as these.

As part of our commitment to openness and transparency, each week we publish numbers of MRSA and C.diff cases acquired (apportioned) in our hospitals.

MRSA blood stream infection – hospital cases

The threshold for the hospital from April 2019 to March 2020 is 0.

Total cases of hospital apportioned MRSA blood stream infections from April 2019 to present = 0.

Clostridium difficile infection – hospital cases

The threshold for the hospital from April 2019 to March 2020 is 32.

Total cases of hospital apportioned C.diff. cases from April 2019 to present = 4.