Hospital-acquired infections ‘well below EU average’

The rate of hospital-acquired infections at Mater Dei Hospital, the Gozo General Hospital and St James Hospital was at 4.6%, well below the EU average, consultant microbiologist Chris Barbara said.

Addressing the parliamentary select committee on health, Barbara said this was a positive result for Malta. With a bed capacity of over 800 beds, Mater Dei Hospital was expected to have a rate of 5% but it transpires that it stands at 4.6%.

The prevention and control of multidrug-resistant organisms (MDROs), such as methicillin-resistant Staphylococcus aureus (MRSA), is considered to be a national priority.

MRSA is known for causing skin infections in addition to many other types of infections.

A major factor in the emergence of antibiotic resistant organisms is overuse of antibiotics in any setting, the hospital or the community.

According to Barbara, 80% of all MRSA in Malta is resistant to methicillin. But due attention by healthcare professionals, including prescribing antibiotics only when necessary and the constant washing of hands by nurses and doctors at the hospitals have succeeded in lowering the rate of MRSA infections.

The Infection Control Department at Mater Dei Hospital has found that the MRSA bacteraemia incidence substantially declined only after the department embarked on a hand hygiene campaign, sought a root cause analysis and introduction of line care initiatives.

“We had expected the incidence rate to go down when the hospital moved to Mater Dei in 2008. But cleaning the walls was not the solution. Only a hygienic environment with healthcare professionals constantly washing their hands proved to be effective,” Barbara said. The positive results were enhanced by changes to the venflon techniques.

MRSA can be passed from person to person by direct contact with infected skin, mucus, or droplets spread by coughs in both adults and children. Indirect contact also can spread the bacteria; for example, touching items like towels, utensils, clothing, or other objects that have been in contact with an infected person can spread the bacteria to other uninfected individuals.

Further screening and monitoring by the Infections Control Department has now found patients admitted at the A&E department had contracted MRSA through the community.

MRSA is resistant to most antibiotics, and the European Centre for Disease Prevention and Control (ECDC) has called for the prudent antibiotic use and comprehensive infection control strategies targeting all healthcare sectors.

According to a 2013 special Eurobarometer survey, 48% of the Maltese took antibiotics in one year – topping the list of EU citizens.

“While 30% were prescribed antibiotics for sore throat, surveys have shown that 30% were prescribed antibiotics for flu and 11% for cold. Fortunately, we are seeing less doctors prescribing antibiotics sporadically and this is evident in year-on-year comparisons which register a decrease in prescribed antibiotics,” Barbara said.

Over four years, Malta registered a 2% reduction in patients prescribed antibiotics by doctors. Pharmacists are now more careful in not giving antibiotics, unless prescribed by the doctor.

The parliamentary health committee –mostly comprised of MPs who are doctors by profession – made sure to deliver home the message that antibiotics should be taken only when prescribed by the doctor and the full course must be followed.