Why politics and MRSA don't mix

MRSA is having a detrimental effect on the UK health economy and our ability to adequately treat hospital-acquired infections. But the desire to combat it with adequately financed and resourced strategies doesn't exist and the transmissible strains that are driving the epidemic go largely unchecked.
The Department of Health wants to reduce the MRSA blood infection rate by 50 per cent by 2008. The government's drive to reduce its impact includes a number of proven measures. Those that interrupt transmission, such as frequent hand-washing by healthcare workers, can significantly contribute to this target.
But hand-washing and improving environmental cleanliness cannot and will not cut in half the existing number of blood infections. Other factors in the overall approach highlight a real failure to tackle the threat radically.
Most hospitals provide alcohol-based washes and staff using them 30-40 times a day after treating patients creates new problems. Hands dry out, become chapped and more amenable to the spread of infection. The policy makes it difficult for health professionals to do their job. There are no current easy solutions to this complex problem.
At the start of the global pandemic in the early 1990s, Dutch hospitals introduced a zero-tolerance policy toward MRSA. All elective surgery cases were swabbed and isolated until their status was known. Levels have stayed low ever since.
But MRSA was already rare in this period. Isolate every new UK hospital admission now and you'd have to increase national capacity by around 30 per cent. It isn't going to happen. Bed-management practices can't even cope with isolating inpatients with transmissible strains and nobody will commit more money.
Infection control can't offer all the answers. There is always an element of chance. Specialisation has increased the volume of inter-hospital transfers and it probably only takes one MRSA colonised emergency referral for the best current infection control systems to be beaten.
Moreover, this is hypothetical. Nobody is certain how MRSA gets into hospitals. Government research funding of £3m was announced in 2003 but this has yet to be spent - does this sound like a health service priority? New strains of MRSA are emerging now with increased resistance and virulence and we may run out of suitable antibiotics in the near future. We desperately need to find out how and why MRSA spreads to prevent this happening.
The mandatory surveillance mechanism demonstrates another failing. Trusts only report numbers of MRSA blood infection. But results from blood isolates are just the tip of the iceberg. MRSA infects many other tissue types and causes dangerous and costly conditions such as abscesses, bone infections and pneumonia.
Furthermore surveillance requires little government spending as MRSA bacteraemia figures are collected locally anyway. Such figures give an indication of how much bacteraemia there is but the true burden of MRSA disease, even the number of MRSA attributable deaths, is unknown. People discharged with undetected healthcare-acquired MRSA, in a boil, for example, are readmitted and the MRSA is not considered a healthcare-acquired infection - and therefore doesn't count in DoH figures.
A simple abscess infected with MRSA can put weeks on an inpatient episode. Cost implications are enormous but if it's not reported can we ever consider prevention strategies?
Preventive medicine and research in this area aren't politically attractive. More political capital can be gained from promises like halving MRSA isolation rates in four years than by announcing serious investment in healthcare systems and research to tackle this scourge of modern medicine.

http://www.hsj.co.uk/nav?page=hsj.news.story&resource=2143860