Page last updated at 23:03 GMT, Monday, 19 October 2009 00:03 UK

Early MRSA discharges called for

Nurse at intensive care bed
Intensive care beds could be under pressure if the expected second wave of swine flu takes off

Hospitals should be discharging MRSA patients early to help ease pressure on intensive care beds as the flu season starts, doctors say.

The MRSA Working Group has written to UK hospitals outlining how to ensure enough critical care beds are available this winter.

They say as MRSA patients get squeezed into fewer beds by flu patients the number of MRSA cases could rise by 40%.

But an MRSA patient group said it was not safe to discharge them like this.

The NHS is preparing for higher than normal levels of staff sickness during the flu season, when both swine flu and normal flu are expected to be circulating.

The MRSA Working Group has warned that reduced staffing levels and a reliance on temporary staff - which is possible if the number of swine flu cases starts to soar - can also lead to an increase in healthcare-associated infections.

'Superspreaders'

A separate study says it is peripatetic healthcare workers such as phsyiotherapists and radiologists, not resident nurses and doctors, who are the potential superspreaders of healthcare infections.

Doctors at the French National Institute for Health and Medical Research say their study shows that if just one of these workers forgets to wash their hands, they play a disproportionate role in spreading the pathogen around the hospital.

Dr Matthew Dryden, of the Royal Hampshire County Hospital and a spokesman for the MRSA Working Group, said: "We normally keep patients in until all their infection parameters calm down.

If this is safe, then why is it not adopted as normal practice to free up beds and reduce costs?
Brian Sams, MRSA Support

"We are suggesting doctors get them out sooner than that, provided they have turned the corner and things have started to get better. "

Dr Dryden said the patients could be given intravenous antibiotics by special nurses at home, or they could go back to hospital for their treatments and some may be put onto newer antibiotics that can be taken orally.

He said there might be problems if an elderly patient had to be discharged back to their nursing home and there were not enough staff to keep the patient isolated from other residents.

"Clearly not everyone will be able to be discharged early - it is one of the factors a doctor will have to take into consideration."

Professor Steve Field, president of the Royal College of GPs, said: "It is entirely sensible to send people out of hospital when they can be safely looked after at home.

"It is good practice for hospitals to discharge patients to care into the community as early as possible."

Death sentence

But Brian Sams, chairman of MRSA Support, said the plan raised deep concerns: "If this is safe, then why is it not adopted as normal practice to free up beds and reduce costs?

"Conversely, there are those who will claim that as our hospitals are so dirty and the home of these 'superbugs', then standard patients who are on the road to recovery and clinically stable may be safer at home.

"What of these discharged people when they catch swine flu? That is probably a death sentence."

A spokeswoman for the Department of Health said: "We have been clear that during a pandemic the NHS must continue to follow the same high standards of infection prevention practice that have significantly reduced MRSA.

"There is no link between MRSA rates and high rates of bed occupancy.

"Over the past few years, trusts with high bed occupancy have reduced their MRSA levels to a similar extent to the low occupancy trusts.

"The NHS is well-prepared to deal with a second wave of swine flu, and has robust plans in place to deal with an increase in the number of swine flu patients alongside winter pressures."



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