ENERGY TECHNIQUE - 2005

This story in Today's Times has a familiar ring to it !...........seems like the NHS just is not interested in a technical solution to MRSA and prefers soap.....

Dalek exterminates ward bugs
By Nigel Hawkes
Machine that kills hospital infections is being ignored by the NHS

THE National Health Service has ignored a British technique for eliminating dangerous infections such as MRSA and Clostridium difficile from hospital wards.

A six-month trial — conducted in the US with the co-operation of the Atlanta-based Centres for Disease Control — has just finished and has provided solid evidence that bugs can be killed using a technique developed by Bioquell, of Andover, Hampshire.

The method was successful at Stoke Mandeville Hospital in Buckinghamshire after it suffered 300 cases of C. difficile infection and a dozen deaths. “We have been trying to set up a trial for the last year in the UK and got nowhere,” said Nick Adams, Bioquell’s chief executive, yesterday. “In the US it took three months to launch the trial and the results were so good we were asked to stay on.”

The problem in the NHS is serious. On Tuesday a report by the Healthcare Commission criticised hospitals for neglecting C. difficile infections, which kill 1,000 people a year in Britain, the same as MRSA. The US results were presented this week at a conference in Washington by John Boyce, the head of the infectious diseases section of the Hospital of Saint Raphael in New Haven, Connecticut. Dr Boyce is a specialist in hospital infections and was one of two who were flown to London by the Department of Health for its MRSA “experts’ summit” in January.

Bioquell’s technique is to empty wards of patients, seal doors and windows and install Dalek-like machines that pump out a mist of hydrogen peroxide, a powerful oxidising agent. When the mist passes the dew point, a near-invisible film is deposited on all surfaces. It kills bacteria without damaging materials. The agent degrades into water and oxygen, so requires no cleaning up. In a few hours the ward is clean and ready for patients to move back in.

The results presented by Dr Boyce were striking. Before treatment, swabs or sponges were used to monitor levels of infection. Of 210 tests in four wards, 51 proved positive for either MRSA, C. difficile, or VRE (vancomycin-resistant enterococci). After treatment, 190 tests were done but none showed any trace of any of the three bacteria. The effect on patients was encouraging. Among those who had been in the hospital for more than three days, and who were admitted from home rather than from a nursing home or another hospital, C. difficile infections were cut by 18 per cent.

Successful one-off trials have been held at St Thomas’ Hospital in Central London, University Hospital, Lewisham, in southeast London, the Royal Hallamshire Hospital in Sheffield, the Royal Free in Hampstead, North London, and Kingston General Hospital in southwest London, in addition to Stoke Mandeville.

But, says Mr Adams, to achieve a long-lasting effect, Bioquell needs to install its own team in a hospital, maintaining biological cleanliness over a long period. This would cost each hospital about £100,000 a year. Going in to clean up a single ward or group of wards, as at Stoke Mandeville, costs about £9,000 per ward. But the health costs of hospital- acquired infections are estimated at £1 billion a year.

Mr Adams blamed outdated medical education for a reluctance to expand the trial. He said that most British doctors were taught that bacteria did not survive for more than a few hours on surfaces, so they did not believe that sterilising surfaces had any real value.

In fact MRSA had been shown to survive for months, and VRE and C. difficile for several weeks.