MRSA: why Ireland can't go Dutch

MRSA or Methicillin-resistant Staphylococcus aureus is a bacterium found on the skin and is resistant to most antibiotics

MRSA or Methicillin-resistant Staphylococcus aureus is a bacterium found on the skin and is resistant to most antibiotics. A person who has MRSA on the skin may not even be aware they have it, but when it enters the bloodstream it can cause many different symptoms and can be fatal.

The Netherlands operates a "search and destroy" strategy on MRSA with the aim of ensuring that MRSA does not become a normal Staphylococcus aureus strain in Dutch hospitals. MRSA currently accounts for about 1 per cent of all Staphylococcus aureus infections in Dutch hospitals. The equivalent figure for Ireland is 42 per cent.

A person regarded as at risk of having MRSA is always isolated when they enter a Dutch hospital for at least three or four days until it is certain they do not have it. These include people who have been in a foreign hospital within the previous two months and people who have had MRSA in the past. After a recent survey found that up to 20 per cent of pig farmers were carrying MRSA, a new policy has been introduced to isolate pig farmers, vets and slaughterhouse workers until they are screened. If staff members are found to have MRSA on their skin, they are immediately sent off duty and treated.

Paul Bergervoet, an infection control practitioner in Deventer hospital in the Netherlands, who spoke recently at a conference organised by the campaign group MRSA and Families, explained that when a case of MRSA was found in the intensive care unit, the entire unit was closed within hours.

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Dr Kevin Kelleher, assistant national director of population health/health protection with the HSE, says Irish hospitals cannot react to MRSA by closing down units in this way because of high bed occupancy rates. This is not possible because "of the history of the way we run our hospitals".

He says Irish hospitals have to take a "risk management" approach and that in order to arrive at a situation such as exists in the Netherlands "we would have to look at how we use our resources, and that is a much larger question".

A recent prevalence study published by the HSE found that at least 4.9 per cent of people in Irish hospitals got a healthcare-associated infection and one in 10 of these had MRSA. "This is too high," he says.

Full approval has been granted for 52 infection-

control posts announced earlier this year, and the recruitment process will begin shortly.

He says €3.8 million was spent in 2006, and that additional resources have been requested for next year.

- Theresa Judge