Friday, January 11, 2008

Keeping a lid on superbugs

NST: KUALA LUMPUR: Imagine being warded at a hospital for a treatable ailment but contracting a life-threatening infection under the very noses of doctors.
This was the fate of nearly 68,000 in-patients in government hospitals last year who were hit by a range of superbugs, many of which were resistant to antibiotics.
Some died but health authorities are unable to provide the statistics. Among the superbugs is the highly-contagious bacteria Mycobacterium tuberculosis.
The number of victims last year was lower than in 2004, when nearly 110,000 were treated for such a problem.
Overall, superbugs affected 5.44 per cent of two million in-patients in 2004 and 3.39 per cent last year.
Common superbugs that cause nosocomial (hospital-acquired) infections include Methicillin-resistant Staphylococcus aureus (MRSA), Staphlylococci, pseudomonads, enterococci and E.coli.
Director-General of Health Tan Sri Dr Ismail Merican said hospital-acquired infections continued to be the bane of many patients warded at government hospitals.
He said while hospital authorities had reduced the number of such infections, a concerted effort was necessary to rid hospitals of the problem.
He has directed government hospitals to provide monthly reports to the ministry on cases of superbug infection.
Dr Ismail, who chairs the National Infection and Antibiotic Control Committee, said government hospitals were part of the National Infection Control System, with units headed by the hospital director or an accredited infectious disease physician.
The hospital committee has to ensure that doctors and nurses strictly adhere to infection control procedures to prevent superbugs from wreaking havoc in hospitals.
"It's a big challenge. I have directed hospitals to take it seriously. The staff must adopt a multi-pronged approach in tackling the problem."
The ministry has also called on healthcare providers to abide by mandatory rulings which included washing of hands after examining a patient.
Infection may begin with a surgical wound or by bacteria spreading through the air.
"With weakened defences, infections that would not normally affect healthy individuals can cause serious illness and death among those who are hospitalised.
"Patients should also wash their hands frequently, especially before and after eating and using the toilet," Dr Ismail said, adding that those who were ill should not visit in-patients.
Key areas where cross-contamination usually occur include examination rooms, the accident and emergency department, intensive care units and coronary care units.
Dr Ismail said infections caught in hospitals tended to be more difficult to treat as bacteria became resistant to antibiotics.
"Nosocomial infections can even be the cause of death among those hospitalised."
MRSA is the most common type of hospital-acquired infection. First identified in the 1960s, it is resistant to conventional antibiotics. Experts have uncovered many strains of MRSA, with differing degrees of drug resistance.
Dr Ismail said the ministry spent RM1 million in 2006 and RM2.5 million last year to provide alcohol-based hand scrub to hospitals to prevent the spread of superbugs.
A larger allocation is expected this year.
The ministry is putting up posters and identifying doctors who adhere to hand-washing procedures to make them role models for other medical personnel.
In Britain, nearly 5,000 patients die of MRSA every year.
The number of MRSA infections in the United States doubled from about 127,000 with 11,000 deaths in 1999 to more than 278,000 with 17,000 deaths in 2005.

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