Tuesday, December 19, 2006


An almost inevitable outcome of dirty hospitals and negligence about aseptic procedures

A healthy hospital worker died after contracting a deadly new strain of MRSA that had never before been reported as a cause of death in hospitals. Four other workers at the same hospital also contracted Panton-Valentine Leukocidin-positive (PVL) MRSA, with two of their friends, said the Health Protection Agency. An investigation subsequently found that the strain had killed a patient at the hospital earlier this year.

The strain, which is particularly virulent, attacks healthy young people and can cause symptoms ranging from minor infections in the skin and soft tissue to a form of pneumonia that can kill in 24 hours. The outbreak, which has only just been reported, was identified when a previously healthy female healthcare worker, named only as “Case One”, developed a severe MRSA infection and pneumonia and died after emergency surgery in September, the agency said. The bacterium that she had contracted, PVL-positive MRSA, had never been found to cause a death inside a hospital. It was contracted by at least three other workers in two wards in a West Midlands hospital, and two of their friends. It was also found to have caused the death of a patient at the hospital in March.

A statement from the agency said: “Eight cases of PVL- positive community-associated MRSA have been identified among individuals in a hospital and their close household contacts in the West Midlands. Four of these individuals developed an infection, two of whom subsequently died.” The agency declined to give further details but said that extensive contact tracing had not identified more cases at the hospital. However, the strain has been found in other hospitals, including the University Hospital of North Staffordshire, which is understood to have identified two non-fatal cases of the bug.

The discovery is significant as hospital-acquired MRSA has tended to affect elderly and infirm patients rather than younger people. PVL is a toxin that destroys white blood cells, which are the key to fighting infectious diseases. It occurs in about 2 per cent of strains of the common bacterium known as staphylococcus aureus, which is termed MRSA when it is resistant to the antibiotic methicillin.

Although it is rare, a small number of cases of PVL- positive MRSA have been reported across England and Wales — however, these have usually been in the community rather than a hospital. The strain is thought to have caused the death of a Royal Marine recruit, Richard Campbell-Smith, 18, in 2004. Forty-eight hours before the young recruit died, he scratched himself on a gorse bush during a training exercise and contracted an MRSA-related infection.

Infections caused by PVL-positive MRSA normally cause skin abscesses or boils and inflammations, but they can cause more severe invasive infections such as septic arthritis, blood poisoning, flesh necrosis and pneumonia. Screening of patients and staff on the ward where Case One worked revealed that one of her friends, a hospital employee who had previously reported skin abscesses caused by MRSA, was carrying the same strain.

Four housemates of the two workers had also contracted the strain. One of these, Case Five, worked in the hospital on a different ward and is thought to have infected another worker there, who detailed a four-month history of recurrent infection of the eyelids. One further case was identified in March 2006 through retrospective analysis of MRSA samples kept in the laboratory. The patient (Case Eight) developed a suspected hospital-acquired pneumonia while in the ward where Case One worked, and died within 24 hours of the positive blood sample being taken.

A spokesman for the Health Protection Agency said that PVL-MRSA was “more toxic than other strains of MRSA”, but it could still be treated with antibiotics. Angela Kearns, an MRSA expert, added: “When people contract PVL-producing strains of MRSA, they usually experience a skin infection such as a boil or abscess. Most infections can be treated successfully with everyday antibiotics, but occasionally a more severe infection may occur. “The Health Protection Agency is advising the hospital on outbreak-control measures, and will continue to monitor MRSA infection nationally.”

PVL-producing strains are more commonly contracted in the community and generally affect previously healthy young children and young adults. This contrasts with the hospital-associated MRSA strains, which do not produce PVL and are more commonly associated with causing wound infections and blood-poisoning in elderly hospital patients.



For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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