Northern Ireland Clostridium difficile deaths and infection continue despite throwing money at it £6 Mn "investment" by McJimpsey

The the Northern Health and Social Care Trust covers Ulster / Northern Ireland. A regional outbreak of patient deaths in which a Clostridium difficile infection has contributed , has continued since last summer.

In total 53 deaths have been attributed to the gut infection , which spreads by faecal contamination , it can be fatal, especially in older patients ( 80% of cases reported are in the over 65-age group) , of these cases , 32 deaths have been recorded since January.

The Trust has just confirmed that there were a further 22 new recorded cases in June with a further 2 deaths in which C. difficile was a contributory factor .

The Northern Trust have undertaken a concerted program of action to contain and eliminate the disease in their hospitals, and the , Health Minister Michael McGimpsey has made available (although he calls it an "investment") of £9m with the very modest aim of reducing MRSA by 10% and C.difficile by 20% by March 2009.

This involves a program of ;

Containment –patients have been nursed in isolation and experience across the country shows that for greater numbers, a dedicated isolation ward leads to greater/speedier reduction as efforts are concentrated in one spot. The Trust designated a ward at Antrim Hospital in January specifically for C. Difficile infected patients. (Standard procedure in Dutch hospitals for decades)

Control use of antibiotics : "Rigorous" reviews and audits of the use of antibiotics. The newer, broad-spectrum antibiotics contribute to the development of infection by eradicating the normal bowel flora and allowing C. Difficile to flourish. To counteract this we have:

- revised the Antibiotic Policies to try to reduce the use of antibiotics associated with C. Difficile;

- audited the prescribing of antibiotics to ensure compliance; and

- informed General Practitioners of the situation and issued revised guidance on the use of antibiotics in the community to them.

Infection control by hand washing , greatly "enhanced" - greatly enhanced environmental dedicated cleaning teams; (i.e doing what they should normally do) plus the replacement of equipment which is not easy to clean.

Hospital visitors to patients with a C difficile infection should wash hands with soap and water before and after visiting their realtive;

- Not bring children , food, or flowers or visit if ill for any reason

- Not not sit on patients beds or touch patient's equipment, and reduce their possession to a minimum - and co-operate with staff.

The US based Committee to reduce Infection Deaths (RID) have a very useful 15 STEPS YOU CAN TAKE TO REDUCE YOUR RISK OF A HOSPITAL INFECTION list which anyone expecting to be hospitalised or has a realtive in or due to go to hospital would should read.

Also read the WSJ article November 27, 2007 Our Unsanitary Hospitals by Betsy McCaughey which promotes the revolutionary idea that food manufacturers, restaurants are tested by outside bodies - why not hospitals ?

Ignaz Semmelweis (b. July 1st 1818 in Buda - 210 years ago ) he said puerperal fever, which killed mothers in childbirth, was spread by dirty doctors. In 1847 he discovered that hand washing with chlorinated lime solutions reduced the incidence of fatal puerperal fever from about 10 percent (range 5-30 percent) to about 1-2 percent. He called them murderers. His contemporraries (and his wife) , quite literally in 1865 had him thrown in a mad house where he died, 14 days later, possibly after being severely beaten by guards. (More)

He is now seen as a pioneer of antiseptic procedures. The stamp above was issued in Austria, 1965, on the 100th anniversary of Semmelweis’ death - although he was strictly a Hungarian . Clever people the Austrians they have convinced the world that Mozart was Austrian and Hitler was a German.