In recent weeks, four patients have died in Glasgow hospitals – three children or children – associated with infections that have risen during their stay. So how much danger are the infections gained in the hospital?
Why do people in the hospital choose new illnesses?
In essence, hospitals are a place with a high concentration of people who do not feel well. Many have already raised infections in the wider community.
Bacteria, viruses and sponges are constantly being transferred to hospitals by patients, visitors and employees. The challenge for healthcare workers is how to stop this proliferation and spread.
A complicating factor is that hospital patients often weaken the immune system and are less able to fight illnesses.
What caused fatal infections in Glasgow?
Two patients who recently died at Queen Elizabeth University Hospital – a 10-year-old boy and 73-year-old woman – were infected Cryptococcus – yeast fungal infection. The most common form in humans is associated with a pigeon or other bird droppings. It is thought that he entered the hospital ventilation system after the birds entered the engine room near the roof.
Another patient seriously ill in a separate one Mucor infection. It is the type of mold that is commonly found in soil or in rotting organic material, such as food. Infection is usually caused by breathing in spores. In this case, it is reportedly a source of water leakage into the patient's room.
Two prematurely born children died and a third seriously ill at the royal maternity hospital of the Princess. They were infected with bacteria Staphylococcus aureus.
They are common bacteria – about a third of us have it on our skin and it's usually harmless. But these "staf" infections, as they are known, can be serious if the immune system is weakened.
Bacteria are usually transmitted by touch – but they can get through the air through skin cell excretion, coughing or sneezing.
How common are these infections?
Infections associated with Cryptococcus or Mucor are relatively rare, but "Staph" infections are much more common.
Staphylococcus aureus represents approximately 110 infections each month in Scottish hospitals.
Bacteria, viruses or other micro-organisms that cause the disease are commonly known as pathogens – and there are plenty of them. Other common varieties found in hospitals are:
- Escherichia coli – better known E. coli. It is a bacteria found in the intestines of humans and animals. It can spread with contaminated food, touching animals or poor hygiene. Some strains, such as E. coli O157, produce toxins that can be very sick, but most people are better than cure. Nearly 400 cases per month are reported in Scottish hospitals.
- Clostridioides difficile – formerly known as Clostridium difficile and abbreviated to C. diff. A very common type of bacteria, especially predominantly in soil, which can cause bowel infection and diarrhea. They can particularly affect people who have been treated with antibiotics or who have been in the hospital for a long time. Almost 350 cases are reported monthly on average for Scottish hospitals.
And what about MRSA?
It is a variant of Staphylococcus aureus that has become resistant to several widely used antibiotics – MRSA actually means Staphylococcus aureus resistant to methicillin. Media is sometimes referred to as a "hospital superbug", as it primarily affects people in hospitals.
This is because these patients often have wounds or catheters that allow it to get into their body. A weakened immune system causes it to be more dangerous – and the concentration of sick people inevitable in the hospital increases the chances of it spreading.
MRSA has become a serious problem in recent years, and many experts have blamed the abuse of antibiotics – overdosing or completing the cycle – which has allowed the proliferation of these resistant strains of Staph bacteria.
What are the hospitals doing?
In Scotland, there is a national infection control strategy including a 10-point list of standard measures:
- Assess patients as soon as they arrive and identify risks
- Hand Hygiene – A detailed set of procedures
- Rules for breathing hygiene and cough
- Protective aid – gloves, double gloves, aprons, eye shadow, etc.
- Equipment – disposable goods, decontamination procedures
- Safe environment – Areas should be visibly clean and cleaning procedures in place
- Bed linen – Safe storage and transport for cleaning, with adequate dirt
- Safe control of blood spilling and body fluid
- Safe disposal of waste including islands
- Safe work practices, training and incident reporting
When an infection is detected, a plan to remove it, including the "deep cleanliness" of the area, is introduced.
National Clinical Director for NHS Scotland Jason Leitch says the rate of infections in the hospital is low but remains a "reality of life in our health care system."
"The fact that this is a rare event gives us much more opportunities to learn and focus on zero," he added.
"That would be our hope that Scotland, even if it would lead the world to fight infections, would improve."