New 'anti-superbug kit' draws mixed reaction from healthcare experts, writes CLAIRE O'CONNELL
IT WAS surely a product waiting to happen. Last week saw the launch of Ireland’s first commercially available “personal anti-superbug kit” targeted at patients who want to “protect themselves against the threat of potentially lethal hospital infections”.
The kit, called Patientpak, consists of a toiletry bag of antimicrobial personal hygiene products, including shampoo, wipes and bed linen spray, which claim to kill 99.99 per cent of germs. The zipped pouch also contains disposable items like a pen, toothbrush and toothpaste that can be ditched before leaving the hospital.
Last June, a report from the Royal College of Physicians of Ireland estimated that 5-10 per cent of patients admitted to acute hospitals develop a healthcare-associated infection. So for someone concerned about contracting a “superbug” like MRSA or C difficile, such a pack might seem just the ticket.
But while patients can certainly help minimise the spread of some infections, there’s more to protecting oneself than cleaning the immediate surroundings, says epidemiologist Prof Anthony Staines from the school of nursing at Dublin City University.
Other factors can facilitate the spread of tough-to-treat microbes that target patients with altered immune systems, like children, the elderly and people with cancer, he notes.
“The important thing is whether the whole hospital is properly run – have they got infection control policies in place, are the staff washing their hands between patients, are there enough staff,” he says.
“Patients need to be aware of what is happening around them, that people are washing their hands, that equipment is not being shared between patients.”
Staines knows the difficulties both as a hospital doctor and a patient – he had a life-threatening MRSA infection nine years ago. He is sceptical about specialised products that target people’s fears. “It’s very much about frightening people, that’s a good way to get people to do stuff,” he says.
“And while I am sure is a perfectly fine product, I wouldn’t buy it because it’s not necessary. It seems to be very much about cleaning ‘you’. So it will stop you catching a virus from your own hands, but if you are infectious you need to be in an isolation room and you will be kept clean as best the nurses can, but you won’t be in a position to infect other people,” says Staines.
“Irish hospitals aren’t perfect, there are problems, but they are doing a lot of work to address those problems.”
However, sociologist Dr Teresa Graham of the group Stop Infections Now believes the healthcare system is not doing enough to clamp down on resistant bacteria like MRSA and C difficile, which, she says, are far more prevalent than official figures suggest.
The reported cases are only the “tip of the iceberg”, says Graham, whose husband died with an MRSA infection in 2004, the year the bug became notifiable in Ireland.
For MRSA, the HSE cites about 430 cases for 2008, but while MRSA bloodstream infection has to be reported, infections of the bone, which can lead to amputation, or of wounds, which can result in disability, or of the respiratory system are not notifiable, explains Graham.
Meanwhile, the figures for C difficile report 2,359 cases in Irish healthcare settings between July 2008 and June 2009, but again the tally underestimates the scale of infection as cases in nursing homes do not have to be reported, according to Graham.
She would like to see further measures taken against the infections here, like increased screening in hospitals – an approach that treats everyone as though they were infected – and also enforcement of hygiene guidelines, such as handwashing for healthcare professionals.
Graham welcomes the introduction of the Patientpak, arguing that it increases awareness of the need for good hygiene in healthcare settings. The Stop Infections Now website (www.stopinfectionsnow.com) also lists 15 suggestions for anyone preparing for a hospital stay.
Prof Hilary Humphreys, professor of clinical microbiology at Beaumont Hospital and the Royal College of Surgeons in Ireland, also welcomes the increased awareness of hygiene issues that the pack could bring, but says that how patients organise their personal hygiene is up to themselves.
“It makes sense for people to prepare for going in to hospital in a non-emergency situation,” says Humphreys, who has been researching healthcare-associated infections for about 20 years.
“But when you are bringing in items to be used in a hospital environment, you have to be careful because there might be regimens in place in the hospital, so make sure they are compatible.”
And he stresses the need for ongoing and multiple approaches to tackle healthcare-associated infections. “There’s no one simple thing that is going to solve this problem, it’s a whole series of things done together and done well,” he says.
“We will never have a situation where we won’t have bugs in our hospitals that may pose potential risk, the bugs are constantly evolving and adapting, so we have to be constantly vigilant.”
Humphreys says there’s a balance to be struck between making people aware and making them scared. “The vast majority of patients who go into hospital will leave hospital without a hospital infection,” he says.