With an outbreak of infection disrupting cancer services at St James's Hospital, Dublin, European figures show the Republic has one of the worst records in Europe for hospital infections.
Health managers were yesterday working intensively to cope with the aftermath of the closure of the haematology/oncology unit of St James's Hospital to new patients with leukaemia and certain other cancers.
The decision to halt admissions was made when 11 out of 26 patients in the unit - which includes the National Bone Marrow Transplant Unit - were found to be infected with Vancomycin Resistant Enterococcus (VRE). The hospital has stressed that the outbreak is confined to the unit.
The hospital is arranging for patients who need bone marrow transplants in the near future to be sent to hospitals in the Republic, Britain and the United States. The Eastern Regional Health Authority was in talks yesterday with hospitals in Dublin and elsewhere to ensure they can take new leukaemia patients to whom St James's may be closed for some months.
VRE, which is present in many healthy people, can cause serious illness in very sick patients. It can be transmitted on the hands of staff, patients and visitors. A subcommittee of the National Disease Surveillance Centre has described VRE as a significant problem in Irish hospitals.
However, a recent report on a related bacterium, MRSA, suggested that some hospitals in the Republic lack infection control facilities (such as isolation units) which are common in Northern Ireland.
And a European study suggests that, among European countries, the Republic has one of the poorest records for MRSA infection, with only Italy, Portugal and Greece faring worse.
The report of the European Anti-microbial Resistance Surveillance System (EARSS) for 1999 showed a prevalence in the Republic which was more than four times that in Germany.
Generally speaking, the northern European countries have tackled MRSA effectively. The survey found no examples in Denmark and hardly any in the Netherlands. Prevalence is relatively high, however, in the UK, Spain and Ireland as well as Italy, Portugal and Greece.
A recently published study of MRSA prevalence in the Republic and Northern Ireland found that 700 hospital patients were infected by MRSA during one fortnight last year.
"Proper handwashing, good antibiotic practice, effective ward cleaning and patient isolation are of crucial importance in reducing the spread of MRSA in hospitals."
However, in a comparison of hospitals, north and south, it found that:
In the North all hospitals had single rooms for nursing patients with MRSA, but in the Republic some hospitals did not have such rooms.
All staff in hospitals in Northern Ireland use gloves and aprons, while only a majority use them in the Republic. "In one acute hospital, gloves were not worn by staff," it noted.
6 per cent of hospitals in the Republic use disinfectants which are not considered effective against MRSA.
The National Disease Surveillance Centre has recommended a number of measures to the Department of Health and Children including:
Strict enforcement of the legal controls on the prescribing of antibiotics. Inappropriate use of antibiotics is blamed for the development of resistant bacteria.
Ensure that all hospital staff and visitors wash their hands as often as necessary.
email: pomorain@irish-times.ie