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You are in: Home Page | Personal Injury | Medical Negligence Claims | General Clinical Negligence Issues | Hospital Acquired Infections

Healthcare associated infections: MRSA, C-difficile and GRE

About Hospital Acquired Infections (HAI)
  Introduction to Healthcare associated infections
A brief description of MRSA
  What is MRSA?
A brief description of C- difficile
  What is Clostridium Difficile?
A brief description of GRE
  What is Glycopeptide Resistant Enterococci?
How to start a compensation claim after suffering from a healthcare related infection
  Start a claim for Hospital Acquired Infection Compensation

About Hospital Acquired Infections (HAI)

Introduction to Healthcare associated infections

There are many types of hospital acquired infections (or healthcare associated infections as they are sometimes known), most of which are potentially preventable.

Such infections can stem from a variety of sources, such as surgical site infections, blood stream infections and transmission through physical contact. In a hospital setting, physical contact is the most common form of transmission and it is therefore essential that the use of alcohol gel employed by hospitals is rigorously upheld and maintained.

Certain medical conditions (such as pneumonia) and procedures (such as catheterisation) can make you more susceptible to contracting infections.

Perhaps the most commonly known infections acquired through health care are MRSA, Clostridium difficile and GRE.

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A brief description of MRSA

What is MRSA?

Methicillin Resistant Staphylococcus Aureus (more commonly known as MRSA) is the most commonly known health care acquired infection. MRSA is a multi drug resistant organism.

It is possible to be colonised with the organism without actually having the disease. Humans can carry MRSA on the surface of their skin and in their noses without coming to any harm. However, if MRSA gets into the body or the blood stream through a break in the skin, infections can start to develop.

There are far more individuals colonised than there are that actually have the disease or become infected.

Contraction and transmission of MRSA

Colonised individuals shed the organism into the environment around them.

Whilst anyone is capable of contracting MRSA, patients with a weakened immune system are most at risk (ie babies, cancer patients etc). Patients who are, or have recently been, on anti-biotics are also at a higher risk of contracting the infection, as are those who have recently had surgery or have open wounds, cuts or burns.

MRSA can be contracted anywhere, but it is most commonly found in hospitals. In hospital settings the most common form of transmission is through the hands of healthcare assistants. Contamination can also commonly occur through direct patient to patient contact or through contaminated objects and surfaces themselves.

Preventing MRSA

All UK Hospital Trusts must have an MRSA protocol in place to reduce the incidence of transmission and infection. There is a National Mandatory Surveillance Programme which all hospitals must adhere to, and National guidelines are set out in the Code of Practice in the Healthcare Act 2006.

A common measure in hospitals includes the screening of patients before elective surgery. Nose swabs are most commonly taken. A full screen (swabbing from the throat, axilla, groin and perineum) will further increase the sensitivity of the test.

Screening of staff is not currently recommended. This is because colonisation can be transient as well as permanent. This means that you can be MRSA positive in the morning and negative in the evening. It is not considered cost effective to remove staff from their working environment for this reason.

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A brief description of C- difficile

What is Clostridium Difficile?

Clostridium difficile (more commonly known as C-difficile or C-Diff) is an anaerobic bacterium that is capable of surviving in an environment for a long time as it does not require oxygen.

The infection is well known for causing mild to severe diarrhoea, but it can also lead to ulceration and bleeding from the colon, which is known as colitis. In worst case scenarios, the infection can lead to peritonitis, which can be fatal.

It is capable of being diagnosed through analysis of a faecal sample of the suspected carrier.

Contraction and transmission of C-difficile

Whilst anyone is capable of contracting C-difficile, elderly patients and those with a serious or severe underlying illness are most at risk. Patients who are, or have recently been, on broad spectrum anti-biotics are also at a higher risk of contracting the infection.

C-difficile can of course be contracted anywhere, but it is most commonly found in hospitals and medical care centres. The risk of infection is also often higher in nursing homes.

A person carrying the disease and suffering from diarrhoea excretes spores into the environment through their faeces. Cross contamination in a hospital setting commonly occurs either through direct patient to patient contact, through contaminated objects themselves, or through hospital staff.

Preventing C-difficile

The Department of Heath issued guidelines dated the 8th February 2007 highlighting three essential principles in managing C-difficile.

1. Anti-biotics should be prescribed prudently, to reduce the use of broad spectrum anti-biotics. This in turn should reduce the number of people at a high risk of contracting the infection.
2. Isolation of patients with C-difficile in a medical care setting.
3. Enhanced environmental cleaning, particularly given the potential long life of the infection. The Department of Health have emphasised the importance of the use of chlorine disinfectant, and the importance of regular hand washing. The use of aprons and gloves are also encouraged, especially when handling faeces and bed pans.

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A brief description of GRE

What is Glycopeptide Resistant Enterococci?

Glycopeptide Resistant Enterococci (more commonly known as GRE) are enterococci bacteria that are resistant to glycopeptide antibiotics.

Enterococci bacteria can be found in most human bowels and there are many different species of it. The majority of infections caused by enterococci are caused by either Enterococcus faecium or Enterococcus faecalis.

GRE is well known for causing wounds infections, blood poisoning and urinary tract infections. In addition, it can cause infections of the bile duct, abdomen, pelvis and the heart valves (endocarditis).

Unlike MRSA, which can occur widely in healthy patients, GRE usually only causes infections in people who are already rather unwell.

It is capable of being diagnosed through analysis of a faecal sample of the suspected carrier. It can be treated through antibiotics (typically linezoid and synercid) although the majority of other anti-biotics are ineffective.

Contraction and transmission of GRE

Whilst anyone is capable of contracting GRE, infections mainly occur in hospital settings. Patients who are immuno-compromised or are on a prolonged hospital stay are particularly at risk of contracting the infection, as are those in intensive care and renal units.

GRE infections can be contracted through two methods. The first method is through cross contamination in a hospital setting by way of patient to patient contact, through contaminated objects themselves, or through hospital staff.

The second way in which the infection can be contracted is by the enterococci bacteria, which often resides harmlessly in the bowel, moving to other areas of the body where it is not normally found. If the infection is contracted by this mechanism, there is nothing a health care provider can do to prevent it from occurring.

Preventing GRE

The Health protection Agency have provided guidelines highlighting one essential principle in managing GRE

1. Enhanced environmental cleaning, particularly emphasising the importance of washing hands before and after visiting patients.

Further research is currently underway with the Department of Health to monitor and combat GRE.

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How to start a compensation claim after suffering from a healthcare related infection

Start a claim for Hospital Acquired Infection Compensation

If you or anyone you know has suffered from any hospital acquired infection or healthcare related infection, telephone us now for accurate claim advice.

There are strict time limits in place to make any personal injury compensation claim. For further information, contact us or visit our Questions Answered page.

Thompsons Solicitors are experts in all matters relating to clinical negligence and will be able to advise you as to whether or not you have a valid claim for compensation. Our specialist clinical negligence lawyers will be happy to talk you through the process of making a claim in plain English and will be happy to answer any questions or queries you may have.

Telephone us now on 08000 224 224 or complete one of our online personal injury compensation claim forms.

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