Scientist criticises Government over its ‘superbug’ strategy

A leading scientist has criticised the Government’s attempts to tackle the MRSA ‘superbug’, saying that proven measures for reducing MRSA infection rates have been overlooked.

In an article in the new edition of Microbiology Today (published 8 February 2005) , Dr Mark Enright, from the University of Bath, says that Government’s efforts to raise basic standards of hospital hygiene are likely to have a limited effect on MRSA infection rates.

Instead, proven measures, such as isolating patients with MRSA infections, should be adopted if the Government is really serious about bringing the MRSA epidemic in the
UK to an end.

However, Dr Enright believes that these measures have been overlooked, despite the scientific evidence that support them, because of the associated increase in costs and potential impact on the controversial topic of waiting lists.

“There ought to be fewer MRSA infections in clean hospitals yet surprisingly there is little scientific evidence for this,” said Dr Enright who is an expert on the evolution and epidemiology of MRSA and a Royal Society Research Fellow.

UK has the second highest rate of MRSA infection in Europe , yet higher rates are reported in the USA and Japan , countries not generally perceived as having failing hospital hygiene regimens

“Better hand hygiene will have some effect, but only a radical measure, such as isolating all patients with particularly transmissible MRSA strains, would really solve the problem. However this would require a politically unacceptable level of resource and lengthen waiting lists.

“Government policy to import experts from European nations with low incidence of MRSA may seem laudable, but it is not at all clear how personnel who are good at keeping MRSA out of hospitals will respond to the challenge of reducing infections”

In the UK , the emergence and domination of two particular clones of MRSA that are not commonly found elsewhere in the world has coincided with increases in MRSA infection rates. MRSA mainly causes invasive disease following infection of tissues around devices placed in the body, such as venous catheters. These are increasingly used in hospitals, as are drugs which suppress patients’ immune systems and enable MRSA to take hold.

“The UK MRSA epidemic may largely be explained by the emergence of particularly transmissible strains of MRSA meeting an increased number of vulnerable hosts. But we simply don’t know how MRSA comes into a hospital, colonises staff and patients and then causes serious disease,” said Dr Enright.

“There is an unacceptably low amount of government spending on research that would give us a deeper understanding of how the MRSA epidemic started, which may allow us to begin to tackle the problem and prevent future epidemics.

“MRSA is changing rapidly and beside hospital strains with resistance to all antibiotic classes, some types are finding niches in the community, causing disease in healthy young people with no prior hospital exposure.

“Hospital hygiene initiatives are all very well but clean hospitals and motivated staff should be the norm and we should be finding out how to eradicate this international problem.”  

For further information, interviews and pictures, please contact Andrew McLaughlin in the
University of
Bath Press Office on 01225 386 883 or 07966 341 357; or Tony Trueman on 01225 384220 or 07966 341322.

Notes

The University of Bath is one of the UK ’s leading universities, with an international reputation for quality research and teaching. In 16 subject areas the University of Bath is rated in the top ten in the country. View a full list of the University’s press releases: http://www.bath.ac.uk/pr/releases

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Rapid Review Panel Backs STERIS VHP(R) Technology for use Against MRSA and Other Healthcare Infection Risks

- Clinical trials and current uses prove the technology

STERIS, a worldwide leader in decontamination and infection prevention, welcomes the 4 February report from the Health Protection Agency (HPA) Rapid Review Panel in favour of STERIS's patented Vaporized Hydrogen Peroxide (VHP(R)) decontamination technology. The panel gives the following recommendation: "It has potential application for fumigating rooms in clinical and pharmaceutical areas including areas containing complex electrical equipment. The product is rapidly microbicidal. Research and development has been completed and the product may have potential value; in use evaluations/trials are now needed in an NHS clinical setting."

Since submitting its information to the Rapid Review Panel last year, STERIS has conducted several clinical trials that reinforce the finding of the Rapid Review Panel and demonstrate the effectiveness of VHP technology against infectious organisms, including MRSA. STERIS has also developed protocols for using VHP technology to decontaminate facilities that are contaminated with MRSA and has developed processes to reduce the potential of MRSA from being transmitted into and out of facilities. This work includes:

- The successful decontamination of hospital wards, isolation rooms, and operating theatres in the UK and abroad

- The decontamination of emergency patient transfer vehicles in the UK and other countries

 - Current research in the UK evaluating the efficacy of VHP technology against SARS and other viruses

  - Research in Germany that confirms the effectiveness of VHP technology against the bacteria which cause tuberculosis (TB)

- A recent investigation, due to be published in 2005, showing that VHP technology can reduce surface contamination even if blood is present

- A report published in the Lancet ( 7 August 2004 ), which proves that STERIS's unique dry VHP process can inactivate prions that cause vCJD and BSE

STERIS invented and pioneered VHP technology and it has been widely used in pharmaceutical and research applications for more than a decade to decontaminate equipment and enclosed areas, providing evidence that it can be a safe and efficacious decontamination process. There are over 80 STERIS VHP systems installed in the UK , 600 across Europe , and more that 1,200 worldwide providing sterile environments in pharmaceutical production facilities and leading research and development labs.

In addition, STERIS VHP technology has been used to remediate anthrax contamination from two U.S. Federal buildings, including a U.S. State Department mail processing facility after the anthrax letters incident of 2001.

Welcoming the Rapid Review Panel announcement, STERIS Limited senior technical director, Dr. Gerald McDonnell said: "STERIS is ready to introduce its VHP technology to the National Health Service (NHS) and work closely with hospitals to ensure its safe and effective application. Our extensive research and practical application has shown that VHP's integrated process can provide a validated solution for reducing the contamination levels in emergency patient transfer vehicles and hospital rooms.

STERIS's VHP technology is easy to apply and can significantly reduce contamination levels to provide a safer environment for patients, medical staff and healthcare workers. Having been used for many years in other industries, we look forward to being able to apply the same technology to help the NHS improve its hygiene standards in healthcare settings."

Simon Williams of the Patients Association commented: "We encourage the use of all technologies which can make a real difference to the MRSA problem in the NHS. We hope a product, such as VHP technology, with apparently such clear evidence in its favour will now see a rapid uptake throughout vulnerable areas of the NHS, such as in ambulances, hospital wards, isolation rooms, and operating theatres. This sort of technology is just what the government needs to help meet its bold new MRSA reduction target."

  Virologist Professor John Oxford of Queen Mary's Medical School, London , said: "This technology has huge potential, all the other evidence already in place illustrates the wide applicability to tackle the threats to health and hygiene. It looks very interesting for tackling a range of viruses including influenza and SARS. Working with STERIS we will be commencing trials for using VHP technology to eradicate influenza and SARS in a matter of days. This work is vital given the ever present threat of a major worldwide influenza outbreak."

STERIS's VHP decontamination technology uses a low temperature, DRY vapour process that has proven to be highly effective against pathogenic organisms and bacterial spores.

The process is environmentally friendly, non-carcinogenic, non-corrosive at use concentrations, and does not leave any toxic residues. Unlike many other antimicrobials, the vapour breaks down into the non-toxic by-products of water vapour and oxygen.

STERIS's VHP technology has been further developed for use in larger enclosed rooms. Recent examples include the decontamination of areas infected with the SARS virus or other viruses, whole building decontamination (for example, anthrax spore remediation), and hospital rooms and vehicle decontamination (including ambulances and aeroplanes). Hospital rooms, including equipment, and other areas can be safely decontaminated without the evacuation of adjacent rooms and with minimum disruption to the hospital staff, patients, and facilities in comparison to other fumigation methods.

STERIS looks forward to making this technology available to the patient care market for day-to-day use and is in discussion with several NHS Trusts now that the Rapid Review Panel has given a clear lead.

VHP(R) is a registered trademark of STERIS Corporation.

Notes:

1. More details of the trials are available upon request, including site photographs.

2. STERIS is the inventor of VHP technology, with more than 1,200 VHP systems in use today. These systems are used in a range of industries, including research and development, pharmaceutical production, an food and beverage packaging. The technology is available now for the National Health Service.

 For more information, visit http://www.steris.com.

3. The February 2005 Rapid Review Panel announcement can be found at:

       http://www.dh.gov.uk/PublicationsAndStatistics/PressReleases/fs/en and

       http://www.hpa.org.uk/infections/topics_az/rapid_review/default.htm

Source: STERIS Limited of Basingstoke

(9/2/05)