MRSA is resistant to the most commonly used antibiotics
A London health special looking at both MRSA and big budget deficits in London Trusts which could threaten patient wellbeing.
The MRSA epidemic first broke out in a hospital in South London ten years ago.
Since then, despite a massive drive to improve hygiene, the number of deaths linked to the bug have increased by nearly a quarter.
Health experts warn that Londoners are especially at risk.
"London is a city with big population, also lots of tertiary referral hospitals, hospitals that do specialist sort of work.
"It is a very intensive environment so it is not surprising we have more MRSA in London", said Prof Stephen Gillespie, from the Health Protection Agency
Recent figures from the Health Protection Agency show a 22% increase in deaths related to MRSA between 2003 and 2004.
What is MRSA?
"MRSA is a bug that lives on our skins, but only becomes lethal in a hospital environment.
"This bug has learnt to become resistant to the main class of antibiotics we use to treat it.
"Most of the time it is not a problem and lives in harmony with us, but if it gets into blood through intravenous lines, that can be a really serious problem and might lead to death", stated Prof Gillespie.
Government set the target to reduce hospital infection by 50% by 2008 - but at the moment, half of all hospitals are behind this target.
What's more, MRSA is nearly exclusively a problem for acute NHS hospitals; MRSA infection is six times more likely to be mentioned on the death certificates of patients in NHS hospitals and care homes than those who die elsewhere.
Latest figures for England and Wales in 2004 show 1,168 death certificates mentioned the infection, up from 955 in the previous year - a rise of 22%.
In 2000 the number was just 669.
Most of the deaths were in older age groups, with higher rates among men than women, according to an Office for National Statistics report.
A personal story
David Felstead's wife, Cherie was 63 years old, when she was admitted to North Middlesex NHS hospital to undergo cancer and bowel treatment.
Soon after, Cherie was found to be infected with 10 strains of MRSA.
When she died, MRSA was mentioned third on her certificate, but her husband David, is convinced it was the infection that killed his wife.
"We were told her illnesses were non life threatening. After she got MRSA, she went down rapidly and I blame the MRSA for her death", said David Felstead.
Health campaigners suspect 'official' figures are not accurate.
"We've got managers who have got an incentives to reduce figures, doctors clearly under pressure not to report cases, unless certain are causes of death and bearing in mind, people are in there for other illnesses, companies, cleaning contractors who want to make things look better than they really are", claims Dr John Lister from London Health Emergency
What is being done to stamp out MRSA?
Ministers have tried to improve overall standards of hygiene, by reintroducing the concept of the ward matron, with responsibility for cleanliness.
There has also been various campaigns and strategy documents issued to hospitals and practitioners.
"We are now legislating to put a hygiene code and a tougher inspection regime into law, to drive up standards of hygiene and infection control, with ultimate sanctions for trusts which fail to deliver." said the Government's Chief Nursing Officer, Christine Beasley.
What is the solution to MRSA?
Experts believe swabbing all patients before they enter hospital, might improve things.
Already, Guy's and St Thomas's NHS hospital in London Bridge is trailing new technology that allows it to have the result within hours rather than days.
This is crucial, because MRSA control isn't just about cleanliness, according to the medical director at the Royal Free in Hampstead.
He blames high figures of MRSA at his hospital (cases, not deaths) on the fact it deals with many dialysis parents (who carry MRSA more than any other patients) and it also has a large number of patients transferred, often in emergency, from elsewhere.
They can bring infections with them onto the ward.
"Swabbing takes 2 or 3 days, but we have business plan prepared and within next two months we should have a test, in which we should have a result within two hours", explained Dr Tookman of the Royal Free Hospital
In the long run, many experts think it may take a breakthrough akin to the discovery of penicillin before humans can regain a temporary upper hand over these "superbugs".
The future for health services in the Capital
Budget deficits of almost £180m in London's hospitals means that primary care for patients may be threatened as they try to balance the books.
The Politics Show London
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