Hospital superbug factor in 42 deaths

Aug 14 2008 by John Rowbotham, Hamilton Advertiser

A HOSPITAL-acquired ‘superbug’ was a factor in no fewer than 42 deaths in Lanarkshire in the six months between December, 2007, and May.

Clostridium difficile (Cdiff) accounted for 20 fatalities at Hairmyres Hospital and 11 at both Wishaw General and Monklands.

The bacteria, mainly spread through cross infection, was the underlying cause of six of the deaths and a contributory factor in the remaining 36.

The deaths occurred among 418 cases of Cdiff at Lanarkshire’s three acute hospitals during the six-month period.

Clydesdale MSP Karen Gillon described the figures as shocking and said she would be seeking an urgent explanation from NHS Lanarkshire managers.

A spokesman for the health board said they had improved hygiene procedures.

Health Protection Scotland (HPS) were asked by Health Minister Nicola Sturgeon to compile data on the incidence of deaths and rates of infection from Cdiff at hospitals throughout Scotland.

It followed the discovery that since December, 2007, there had been 54 cases of Cdiff infection at the Vale of Leven Hospital in Dunbartonshire.

The virus was a factor in 16 deaths at the Vale of Leven hospital since December.

HPS, who were set up by the Scottish Executive four years ago and are the watchdog for health protection north of the border, found that over the six-month period there were 3174 Cdiff cases in Scotland and 285 Cdiff-linked deaths.

Hairmyres had five Cdiff associated deaths in January and a further six in March.

Of the 418 Cdiff cases in Lanarkshire hospital between December and May, 157 occurred at Hairmyres, 144 at Wishaw General and 117 at Monklands.

Seventy-seven cases involved people under 65 and 341 cases concerned those over that age.

HPS noted in their report that in February at Wishaw General there were 31 cases of Cdiff, a higher than expected incidence of infection.

The report states, however, that the hospital identified the problem at the time and introduced measures aimed at controlling the infection.

Alison Graham, NHS Lanarkshire's medical director, said they were investing significantly in training, staffing, patient and relative information and monitoring controls to tackle the infection problem.

She added: “We also need patients and relatives to work with us in terms of good hand hygiene compliance to prevent the spread of infection in hospitals.”

Some of the additional measures that have been introduced to curb cross infection include the employment of two ‘hand hygiene co-ordinators’, improvement of signage and patient information leaflets, and ensuring consistent reporting across the three hospital sites.

Two antimicrobial pharmacists have also been taken on and the board’s policy regarding use of antibiotics – believed to be linked to the spread of hospital-acquired infections – has been “re-launched”.

Mrs Gillon said the infection figures would be on the agenda next month when county MSPs and NHS Lanarkshire managers hold their quarterly meeting.

“The figures are shocking and much higher than I would have expected for Lanarkshire,” she said. “The health board need to provide a clear explanation as to why it is happening and what steps are being taken to alleviate the problem.”

She wants to know how effectively infection was contained, and whether there is a case for reviewing the way in which wards are cleaned.