Thursday, 30 January 2003
Seanad Eireann Debate
Mr. Morrissey: I welcome the Minister of State. I raised this motion on the Adjournment because I became aware of this problem with MRSA recently when a person I know suffered from it. I understand that it is quite prevalent in hospitals and is an ongoing concern within hospitals countrywide.
The source of it is hard to understand, but the recuperating process for patients who get this bug is quite serious. It is not exactly life-threatening, but it certainly extends their stay in hospital and, therefore, does not free up beds for people who might wish to enter hospital for surgical procedures. I ask the Minister to give us whatever information the Department has on the prevalence of MRSA and on what actions are taken in hospitals, particularly in regard to geriatric patients coming from a district hospital to a surgical hospital for procedures to ensure that it is not carried among that population cohort.
Mr. B. Lenihan: I thank Senator Morrissey for raising this matter on the Adjournment. MRSA is a significant infection which occurs in hospitals and in the community. It is a major issue for health care systems in all countries. There are many contributing factors, including the use of antibiotics and the control of infection in our hospitals.
MRSA is part of the broader issue of antimicrobial resistance and this is being addressed in a number of ways. Guidelines for acute hospitals and other facilities on the control of MRSA were developed and circulated to health boards and other relevant parties in 1995. In 1999 a North-South study on MRSA prevalence was undertaken under the direction of the Eastern Regional Health Authority. This was a follow-up to a previous study carried out in 1995.
This study provided much useful data and also made a range of recommendations for the control of MRSA. These included identification of a wide range of issues which needed to be addressed at hospital level. The guidelines issued in 1995 suggest a variety of options for nursing patients with MRSA.
In 1999 my Department also asked the National Disease Surveillance Centre – NDSC – to evaluate the problem of antimicrobial resistance, including MRSA, in Ireland and to formulate a strategy for the future. The NDSC drew up a Strategy for the control of Antimicrobial Resistance in Ireland – SARI, which the Minister for Health and Children, Deputy Martin, launched on 19 June 2001. This report contains a wide range of detailed recommendations to address the issues which can be grouped into five categories, as follows: the surveillance of antimicrobial resistance; the monitoring of the supply and use of antimicrobials; the development of guidance in relation to the appropriate use of antimicrobials; education; and the development of principles in relation to infection control in the hospital and community setting.
Tackling the problem of antimicrobial resistance is a multifaceted issue which will require action on a number of fronts. Since 2001 approximately €12 million has been provided to the health boards for antimicrobial resistance measures, taking into account the recommendations in SARI and in the North-South study of MRSA in Ireland in 1999. The boards have been asked to address, in particular, infection control strategies and staffing in both hospitals and the community, the development of surveillance systems for the collection of antimicrobial resistance data and information on antibiotic prescribing in hospitals.
The report recommended that a national SARI committee be established in order to oversee the implementation of the recommendations in the report and to develop guidelines, protocols and strategies in relation to antimicrobial resistance. This committee has now been established and held its first meeting in December 2002.
The NDSC collates information on the incidence of invasive MRSA as part of the European antimicrobial resistance surveillance system – EARSS. This is collected on a quarterly basis and is available only in aggregate form. Details are available on the NDSC website – www.ndsc.ie. Information on individual hospitals is not available.
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