Superbug shock at Conquest

The hospital ranked equal ninth in a league table produced by the government's Office for National Statistics, and there were calls this week for stricter hygiene rules to be introduced at the Conquest to prevent the spread of the infection.

The highest number of deaths where the bug was present in 2002 was 22, at Derriford Hospital, Plymouth, out of a total for England and Wales of 721.

A spokesman for the ONS said: "These figures will have been taken from death certificates where the doctors who certified death have given it as a contributory factor."

But with no legal obligation to report the presence of methicillin-resistant staphylococcus aureus (MRSA) on death certificates in the same way that health trusts are legally obliged to record diseases like meningitis, there are fears the real number of deaths where the bug is present could be far higher.

A separate National Audit Office study estimates that the number of MRSA-related deaths could have been as high as 2,000 in the same year.

MRSA is present on the skin of thousands of healthy people, but it enters the bloodstream through open wounds, making hospital patients vulnerable.

The Hastings Observer received a letter this week from an elderly hospital visitor shocked at the sloppy standards she says she witnessed at the Conquest.

She was angry at not being warned that the friend she was visiting had MRSA. The patient was alongside others, and "at no time were we warned of any effects it would have on oneself".

She added: "Those serving food had no protective clothing, no gloves, no hat, and altogether the whole thing was unhygienic.

"The nurses travel on buses in the uniforms they have been wearing among contaminated patients. How can the disease be corrected if this is the usual procedure?"

This week the Conquest announced it was tightening up hygiene rules. Alcohol gel dispensers have been installed to ensure more people gel their hands on arrival and departure to the wards. The uniform policy is also being reviewed, though the infection risk from uniforms was "very small", said a spokesman. He added: "Staff on the wards should wear a gown and gloves when serving food. As an additional measure to reduce the risk of infection we are soon to pilot providing patients with hand wipes at each mealtime."

Consultant microbiologist at the Conquest Dr Paul Wright stressed that it is rare for the superbug to be the main cause of death and these figures are of deaths where it has been given as a contributory factor. "Clinically, it is very difficult to determine what contribution MRSA made to a patient's death even if it appears on a death certificate. It is unusual for MRSA to be the sole cause of death however, it often contributes to a patient's death.

"The figures published in the Sunday Times may well underestimate the number of patient deaths where MRSA has been a contributory factor to a patient's death. The reality is we will not know the true extent of the problem until there is a proper nationwide study and we welcome the Chief Medical Officer's request for an audit into this problem.

"We do screen orthopaedic patients prior to surgery but remain to be convinced if it would be beneficial in terms of time and resources to screen all patients prior to admission."

He said the East Sussex Hospitals NHS Trust took hygiene and cleanliness seriously and were regularly inspected on its standards. "We have an active infection control team of specialist doctors and nurses across the Trust who are responsible for ensuring staff comply with agreed hygiene control. They are supported by clinical matrons on the wards who constantly remind medical and nursing staff of the need to follow infection control measures. Our CHARM offensive, which stands for Clean Hands Are Really Magic, has proved to be an effective method of reminding staff of the importance of hand hygiene.

"MRSA is a big challenge that affects the whole community and every hospital in the country. The prevention and control of infections is an important part of patient care. This can be achieved with good hand hygiene with healthcare professionals always washing or cleaning their hands thoroughly in-between treating patients. Patients and visitors to hospital can also have their part to play in the control of hospital infections by following all the hospitals preventative measures. Each patient has the right to challenge all their carers about the cleanliness of their hands."