The imposition of punitive financial penalties for exceeding targets for healthcare-associated infections in this context is unlikely to improve infection control practices, and nor is it likely to benefit patients.
- Estee Torok
The zero-tolerance approach to methicillin-resistant Staphylococcus aureus (MRSA) infections in UK hospitals has failed to take account of cases that may be unpreventable, a new study from the University of Cambridge suggests.
The study, carried out by a research team working at Addenbrooke’s Hospital, Cambridge, investigated a possible outbreak of infections on one of the wards, by sequencing the genomes of MRSA isolated from four affected patients.
The analysis, however, which is published in the Journal of Antimicrobial Chemotherapy, found that the incident was not an outbreak at all. Each of the four patients had a genetically distinct strain of MRSA, and these were highly diverse when compared against a global collection of MRSA samples taken from 15 countries over a period of 20 years.
These findings suggested that, rather than being transmitted between patients on the ward, the MRSA had, in each case, been imported into the hospital by patients, having been acquired elsewhere in the healthcare system.
The researchers argue that this raises serious questions about the feasibility of a long-standing “zero-tolerance” approach to MRSA, which does not take into account the fact that the risk of acquiring it – and of developing subsequent bloodstream infection – varies between different patient populations.
Dr Estée Török, an Academy of Medical Sciences / Health Foundation Clinician Scientist Fellow and Post-Doctoral Researcher at St John’s College, Cambridge, was the study’s lead author. She said: “Since the late 1990s, successive governments have talked about a zero-tolerance approach to MRSA. This was originally a policy applied to fighting small-scale crime in America. To apply it to the health service is a flawed concept, but in spite of that, it is now becoming an established view.”
“We should absolutely be aiming to get MRSA rates as low as we can, but there is little point in setting a standard which is unachievable without unrealistic levels of investment.”
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Image: Hospital-Associated MRSA Bacteria
Credit: NIAID via Wikimedia Commons
Reproduced courtesy of the University of Cambridge
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