September 24, 2007

scientists respond to call for deep cleaning hospitals in order to control superbugs

Prime Minister Gordon Brown announced plans for ward-by-ward deep cleaning of hospitals to tackle superbugs such as MRSA.

Professor Richard James, Professor of Microbiology, University of Nottingham, said:

“Deep cleaning of hospitals may help a little but it is only a small part of the required solution to the complex, multi-faceted problem of hospital infections. It would be more likely to make a difference with C.difficile, where transmission of the organism is by the faecal-oral route. In the case of MRSA, where transmission is principally by person to person contact, it would make very little difference.”

Dr Mark Enright, Imperial College, London, said:

“My view is that deep cleaning would largely be a waste of resource and an inconvenience to patients and healthcare staff. For hospital-acquired infections and MRSA in particular, there is no robust scientific evidence linking a contaminated environment to human infections. MRSA is a major problem in the UK because it is present, mostly unknowingly, in patients and staff (and note – not usually visitors). Interrupting the chain of transmission from these people to new hosts should be the main focus of infection control, not attempts at the sterilization of floors and windows. A strategy employing the “deep cleaning” of people is possible if MRSA is detected before they are allowed to pose a risk to other patients but this would require isolation until the results of detection are known.”

Professor Brendan Wren, Professor of Microbial Pathogenesis, London School of Hygiene and Tropical Medicine, said:

“The “deep clean” approach will at best only be a temporary solution and could theoretically make matters worse. Clostridium difficile forms spores; it is persistent and hard to shift.

“The real problem is that there is a new C. diff bug (the 027 strain) that has evolved to be very persistent and very transmissible. The US and Canada had the 027 problem before the UK, so it is not a case of the dirty British.

“We have to go for a long term solution and really understand what make the 027 strain tick. Very little money is spent on basic and translational research for C. diff, indeed the public would be shocked (less than a million per year for the UK). Despite the lack of resources there have been several breakthroughs in C. diff research including the genome sequence of the 027 and other strains. So for a relatively small investment in basic science, a big difference could be made.”