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Last Updated: Thursday, 27 September 2007, 23:21 GMT 00:21 UK
Superbug plans 'ignore' evidence
Hand washing
Hand washing is the most effective way of battling MRSA
Government plans for tackling superbugs, such as MRSA, have been condemned by a leading medical journal for not being based on scientific fact.

The Lancet said there was little evidence to support hospital "deep cleans" or short-sleeves for medical staff as recently proposed.

Instead of "pandering to populism" politicians should listen to the evidence, the editorial said.

The government said the plans were part of a wide range of preventive measures.

On Sunday, Prime Minister Gordon Brown announced plans to "deep clean" hospitals ward-by-ward over the next year to return hospitals to the state they were in when they were built.

The main route of transmission of MRSA is person to person contact and this will be affected little by deep cleaning
Professor Richard James, Nottingham University

His comments followed proposals from Health Secretary Alan Johnson for a new dress code for NHS staff which would advise against long-sleeved coats and ties for doctors as they can become contaminated.

But The Lancet said a government working group had found no conclusive evidence that uniforms or other work clothes posed a significant hazard in terms of spreading infection.

And the focus should be on disinfection of high-touch surfaces rather than deep-cleaning wards to get rid of visible dirt, the journal said.

The editorial said: "Brown also plans to double the number of hospital matrons, to check on ward cleaning, and accost doctors wearing long sleeves.

"They would be better employed making sure doctors, nurses and visitors wash their hands properly, the proven way to stop hospital acquired infections," the editorial stated.

Person-to-person

Professor Richard James, director of the Centre for Healthcare Associated Infections at the University of Nottingham agreed the evidence on transmission of infection from clothing such as long sleeves was not clear but short sleeves may encourage staff to wash their hands properly.

He added: "The main route of transmission of MRSA is person-to-person contact and this will be affected little by deep cleaning.

"In contrast, Clostridium difficile is transmitted by contact with faecal contamination so it may be more effective here."

He said in addition to hand washing, other useful strategies would be screening patients for MRSA on admission, regular use of hydrogen peroxide vapour generators to kill bugs in the hospital environment and educating patients and visitors on ways they can reduce risk.

Chief Nursing Officer, Professor Christine Beasley said there was no single solution and the new proposals were part of a wider set of measures to reduce hospital-acquired infections.

She agreed that there was no evidence that uniforms themselves pose a significant risk of transmitting infections but said long sleeves and watches "get in the way of washing and decontaminating the hands, wrists and forearms".

"Clean and tidy hospitals and staff are very important to patients," she said.

"We make no apology for asking hospitals to take every reasonable measure to reduce infection and increase patient confidence that this is an issue the NHS is taking seriously."

Dr Mark Enright, an expert in molecular epidemiology at Imperial College, London said deep cleaning would be a waste of resources and an inconvenience to patients and staff.

"MRSA is a major problem in the UK because it is present, mostly unknowingly, in patients and staff.

"Interrupting the chain of transmission from these people to new hosts should be the main focus of infection control, not attempts at the sterilisation of floors and windows."


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