MRSA ‘superbug’ infection rates slashed by half

Infection rates of the Methicillin-resistant Staphylococcus aureus bacteria (MRSA) in the bloodstream have dropped by more than half in the last three years among patients at Mater Dei hospital, according to information released by the Health Ministry.

MRSA is an anti-biotic resistant bacterium that has been present in Maltese hospitals since 1995. It is regarded as a major health risk in hospitals, prisons, nursing homes and other confined environments.

"Mater Dei Hospital has adopted a wholesale strategy based on surveillance, antibiotic stewardship and infection prevention and control," a ministry spokesman told MaltaToday.

"These results are indeed evident with a substantial reduction in antibiotic consumption at hospital level, four-fold improvement in hand hygiene, zero rates for bloodstream infections following the use of central lines in intensive care, and reduction in the incidence of healthcare associated MRSA bacteraemia (MRSA bacteria in the bloodstream) which is now less than a half of what it was just three years ago."

The official was responding to a recent survey which placed Malta's healthcare system second from last in a comparative analysis between healthcare systems in European member states.

The Eurohealth Consumer Index (EHCI) 2013 was conducted by the Health Consumer Powerhouse (HCP), to provide a comparison of practices and standards for healthcare from a consumer point of view across the 27 EU member states, Norway and Switzerland. In five categories, covering 42 performance indicators, Malta scored 559 points from a potential 1,000.  Malta's healthcare was ranked 26th across Europe.

The relatively high incidence of MRSA was among the many factors that had contributed to Malta's poor rankings in this list.

The first local case of MRSA infection occurred in St Luke's Hospital in 1995, and concern with the incidence of this antibiotics resistant bacterium grew to significant levels before migration of facilities to Mater Dei in 2008.

But it was in November 2011 that Marc Sprenger, Director of the EU's Centre for Disease Prevention and Control (ECDC) revealed that Malta, alongside Italy, Spain and Greece, had among the highest incidences of MRSA present in hospitals in the European Union.

By then measures were already in place to contain the epidemic. There were 28 MRSA infections in blood identified at Mater Dei in 2011: down from 31 cases in 2010 and the 39 identified in 2007 at St Luke's.

Among the practices introduced in 2011 to combat the disease was an increased insistence on hand-hygiene among doctors and hospital staff. A 2007 study by the St Luke's Hospital infection control unit identified hand-hygiene as a major factor in the spread of MRSA, and observed very low compliance with hand-hygiene regulations among staff in all departments.

Mater Dei Hospital now screens all patients admitted into the higher risk wards for the deadly superbug MRSA by means of a nose swab; special disinfectant creams and soaps are available treat detected infections.

Another factor that may have contributed to Malta's relatively high MRSA incidence is the fact that there is only one centralised general hospital, which is in turn prone to overcrowding. The Eurohealth Consumer Index identifies this situation as an agent in facilitating bacterial infections.

A spokesman for the health ministry confirmed that upcoming National Health Systems Strategy, which is expected to be launched for consultation in the first quarter of 2014, will address this issue, which also has broader implications than infection control alone.

"The shift of the focus of the health care model away from hospital (or secondary) care towards primary care has indeed been recognised internationally as the way forward in health care. The arguments in favour of such a move are not only in terms of costs and sustainability of the health care services, but also in terms of accessibility. Services provided in primary care are typically based in the community and would therefore be more accessible and convenient, particularly for those whose mobility may be limited. The government also strongly believes in this vision and has already committed itself strongly to the development of the primary care sector in both the electoral manifesto and the budget for 2014."