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Wednesday, July 15, 1998 Published at 12:35 GMT 13:35 UK


Health

'Don't panic over superbugs'

Elderly and other vulnerable people are at risk from hospital bugs

Claims about hospital superbug MRSA have been exaggerated, leading to ineffective panic measures to search and destroy it, according to a leading doctor.

Writing in The Postgraduate Medical Journal, Mustafiz Rahman, a microbiologist from Nottinghamshire, says there has been a lot of hype about the superbug which has led to exaggerated reactions to it.

The British Medical Association recently debated the bug, which many patients contract while in hospital. Research shows that one in 10 people contract some form of illness while in hospital, many of them from bugs such as MRSA.

Patients suspected of carrying the bug have been isolated and hospitals have instituted a search and destroy policy against it.

Staff who have come into contact with the bug have been screened as well as new patients coming into hospitals.

Mr Rahman says this has proved very expensive and disruptive. He claims screening may not be reliable and that some strains of the bug disappear naturally.

Unreliable

He says the bug may hide in "unusual body sites", making it difficult to detect. "This means that one has to continue sampling from multiple body sites for weeks or even months to be sure of reliable negative results, resulting in huge numbers of samples examined per patient in some cases," he writes.

Many patients who contract the bug, which is present at the back of most people's throat in a non-harmful form, are elderly. Mr Rahman says they may be long-stay patients and will have to be isolated for months to ensure the bug has been eradicated, leading to long-term psychological effects.

MRSA is the most well-known of hospital bugs, but Mr Rahman says it has also been found in nursing homes and GP premises, showing it is now widespread in the community. He believes this shows that selective screening in hospitals may be impractical.

Guidelines

MRSA was first identified in the 1960s. The first British guidelines for dealing with bug were drawn up in 1986 and have been revised twice since. Further alterations are expected later this year. Mr Rahman says the changes show that the measures have not been effective.


[ image: Mr Rahman says MRSA has also been found in GP surgeries]
Mr Rahman says MRSA has also been found in GP surgeries
He says MRSA usually causes only minor infections, although it can be fatal in already vulnerable patients. But he says there is no proof it is more virulent than other similar bugs. And he says it is untrue to say it is resistant to all antibiotics except vancomycin.

He says the bug is resistant to at least five different types of antibiotics and new drugs are coming onto the market.

Living with superbugs

"The situation does not really call for desperate measures," he writes. "It might be cheaper and easier to treat clinical infections when they arise than trying routinely to identify and treat all colonised cases."

However, he agrees that the introduction of special measures may be justified in some cases.

He says: "It seems that the special measures introduced to control or eradicate MRSA have not succeeded...There is no justification to continue with the 'search and destroy' policy. It is time that we learnt to live with MRSA in the way we have been living with many other pathogens."



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