Impact of hospital infections on our

Transcription

1 Impact of hospital infections on our ageing population Professor Peter Lambert School of Life and Health Sciences P. A. Lambert Slides are for personal use only. They are NOT for reproduction or publication

2 Importance of healthcareassociated infection in the UK 300,000 healthcare-associated infections per year in UK 9% of patients acquire an infection whilst in hospital 11 days average extension of hospital stay 5,000 patients die of complications from these infections cost to NHS 1,000,000,000 per year The hospital Superbugs: MRSA and Clostridium difficile

3 What is MRSA? Staphylococcus aureus is a bacterium found on the skin and nose (about 30% of the population)

4 and can be passed on by touch.. We all have bacteria on our hands

5 What is MRSA? Strains of Staphylococcus aureus that are resistant to methicillin (a penicillin antibiotic) MRSA are carried by about 1% of the population Found in hospitals: healthcare workers (HCW), patients and in the community Transmission: patient to patient; environment to patient; HCW to patient

6 Many infections are caused by MRSA

7 MRSA bloodstream infection: 70% are of age 65+

8 MRSA-related deaths Office of National Statistics Bloodborne MRSA infection rates to be halved by 2008 John Reid Nov 2004

9 How? Use antibiotics more carefully Keep hospitals clean Effective hand washing Less crowding Close wards MRSA screening

10 MRSA deaths have decreased Office of National Statistics Good news...

11 MRSA bacteraemia reports, January 2009 to March but rates are still too high

12 Clostridium difficile Causes antibioticassociated diarrhoea 10 x more common than MRSA Difficult to eradicate

13 Range of effects 20% acquire C. difficile in hospital can be asymptomatic but >30% of these develop diarrhoea 3% colitis death Normal Colon Pseudomembranous colitis (PMC)

14 Rates of C. difficile positive faecal specimens England, Wales and Northern Ireland, 2009: 77% are age 65+

15 Reports of C. difficile positive faecal specimens: England, Wales and Northern Ireland

16 C. difficile: hyper-virulent strains 2004: Canadian outbreak 7000 sufferers and 600 deaths in Quebec Hyper-virulent strain (027) 2005: Identical strain accounted for 12 deaths and 300 infections at Stoke Mandeville Hospital : 90 deaths and 1170 patients infected at Maidstone and Tunbridge Wells NHS Trust 027 is now reported across UK and other parts of Europe other strains: 001, 106

17 Maidstone & Tunbridge Wells Deaths 1170 Cases Police Investigation Chief Exec. resigned

18 Clostridium difficile deaths fall Office of National Statistics Good news...

19 CDI reports, January 2008 to March but rates remain too high

20 National Audit Office Report Twenty nine per cent of hospital trusts have reduced C. difficile infections by over 50 per cent, but 19 per cent have had an increase in C. difficile infection. More work is needed...

21 Aston are supporting clinical trial of copper touch surfaces

22 Copper surfaces may help control superbugs

23 Copper vs superbugs in the hospital setting 18-month trial to investigate the effect of replacing steel fittings with copper and copper alloys.

24 Study at Selly Oak Hospital has compared number of bacteria on copper and non-copper surfaces in a surgical ward

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26 Copper cuts contamination between cleans Numbers of bacteria on copper-containing items are reduced by >90% compared to controls in the clinical setting

27 We would like to thank all the suppliers of the copper items: Aalco, Allgood plc, Aurubis, Doyle & Tratt, Frank Allart, IBP, McDonald Diecastings, Mercury Composites, Nottingham Rehab Supplies, OMC Engineering, Rycroft Ltd, Triflow Concepts, TW Stampings Ltd

28 Stopping the spread of C. difficile spores: germinate, exterminate Spore germinants to sensitise C. diff spores to disinfectants Dr Tony Worthington and Dr Laura Wheeldon, Aston

29 Germinate, exterminate works on copper surfaces CFU/ml Log Spores on steel Spores on copper Spores and S.T on steel Spores and S.T on copper Spores, S.T. and soil on copper Time (mins) Tony Worthington, Dan Rathbone, Laura Wheeldon and Christian Lowden: Spore germinants used to sensitise C. difficile

30 Summary Risk of healthcare-associated infection increases with age Cleanliness is key to prevention Copper alloy touch surfaces reduce the risk of patients acquiring infection in healthcare environments Same principles apply to home and long term care facilities

31 Infection: are we winning? No, but we can keep one step ahead future will be better tomorrow

32 Thank you!