Infection Information

The two most common infections that we are commonly dealing with are MRSA and C.diff


MRSA


MRSA (often referred to as the superbug) stands for methicillin-resistant Staphylococcus aureus (SA). SA is a bacterium from the Staphylococcus aureus family.


About 30% of us carry SA on the surface of our skin, or in our nose, without developing an infection. This is known as being colonised by the bacteria. However, if SA bacteria get into the body through a break in the skin they can cause infections such as boils, abscesses or impetigo. If they get into the bloodstream they can cause more serious infections.


MRSA is no more infectious than other types of SA bacteria. However, MRSA infections are more difficult to treat due to the antibiotic resistance of the bacteria.


MRSA was relatively uncommon through the 1960s and 1970s. A few more cases appeared in the 1980s, but the problem exploded in the mid-1990s when particular 'epidemic' strains of MRSA became established in hospitals throughout the UK. These strains are easily transmissible (passing between and colonising both patients and hospital staff easily) and have the capacity to cause serious disease. These strains now represent over 40% of the S.aureus causing bloodstream infections in England.


Staphylococcus aureus (including those that are MRSA) causes a wide range of infections from asymptomatic colonisation (where the MRSA is doing no damage but is still capable of causing clinical infections) to fatal septicemia (the most severe form of blood stream infection).

What does MRSA cause in patients?

MRSA is more often spread by touch – If a person gets MRSA on their hands, they can pass it on to other people and on to things that they touch. It can then be picked up and passed on to others
British people have been infected for the first time by an animal variant of MRSA, the hospital superbug that infects more than 4,000 patients a year.

C. diff

Clostridium difficile (C. diff) is a bacterium that is present naturally in the gut of around 3% of adults and 66% of children.


C. difficile is a bacterium of the family Clostridium (the family also includes the bacteria that cause tetanus, botulism, and gas gangrene). It is an anaerobic bacterium (i.e. it does not grow in the presence of oxygen) and produces spores that can survive for a long time in the environment
Although C. difficile was first described in the 1930s, it was not identified as the cause of diarrhoea and colitis following antibiotic therapy until the late 1970s.


Patients who have been treated with broad spectrum antibiotics (those that affect a wide range of bacteria, including intestinal bacteria) are at greatest risk of C. difficile disease. Most of those affected are elderly patients with serious underlying illnesses. Most infections occur in hospitals (including community hospitals), nursing homes etc, but it can also occur in primary care settings.

Although some people can be healthy carriers of C. difficile, in most cases the disease develops after cross infection from another patient, either through direct patient to patient contact, via healthcare staff, or via a contaminated environment.

They can survive for a long time and be a source of hand-to-mouth infection for others. If these others have also been given antibiotics, they are at risk of C. difficile disease.

Other common infections frequently related to poor hand-washing

E-Coli

The report into the E-Coli outbreak in South Wales in September 2005 that left one school child dead, found that hygiene standards were ‘below what was required to prevent disease transmission.’ Welsh inspectors (Estyn) found that toilets in half of secondary schools and a quarter of primary schools inspected in Wales were dirty or unacceptable.

Diarrhoea and winter vomiting

Professor Mike Catchpole, director of the Health Protection Agency's Centre for Infections, says, "It is well known that hand washing is one of the most important ways of controlling the spread of infections, especially those that cause diarrhoea and vomiting.” "Norovirus (winter vomiting bug) is highly infectious and easily spread in settings where people are in close contact with one another so good hygiene, including frequent hand washing, is really important." (BBC News Online)

Acute diarrhoea

Short-term diarrhoea is usually a symptom of gastroenteritis, which is an infection of the bowel. Gastroenteritis may be caused by:

  • A virus, such as norovirus or rotavirus,
  • Food poisoning - usually caused by salmonella, campylobacter or staphylococci bacteria,
  • An Escherichia coli bacterial infection, which causes secretory diarrhoea (see box, right),
  • Antibiotics, or
  • Contaminated food or water from a foreign country, causing 'traveller's diarrhoea'

Salmonella sp. is a rod-shaped bacteria with over a thousand strains capable of causing infection (salmonellosis). Salmonella is easily transferred among humans and animals by both direct and indirect contact. The great increase in mass production of certain food products, including poultry and eggs, has resulted in a large increase in salmonella infections. In uncooked, room-temperature food, Salmonella multiplies at an alarming rate. In addition to other strict hygiene practices when handling uncooked poultry and raw eggs, scrupulous hand washing is necessary, using hot and soapy water.