Dr Nick Williams – Environmental Advisor – PHS Group plc

Basically, the ‘SA’ refers to ‘Staphylococcus aureus.’ This is a very common bacteria which we all have living in our noses and on our skin as part of our own personal bacterial load. Its commonest effect is to sometimes cause minor infections of skin cuts, etc, the ‘septic’ effect.

Where this bacteria may cause a problem is in hospitals and nursing homes, where the local bacteria may become resistant to some of the more commonly used antibiotics, and so infections can be difficult to treat conventionally. This is where the ‘MR’ bit comes from, as it means ‘methycillin resistant’ and denotes the type of antibiotic to which S. aureus has developed resistance. This is currently a hospital phenomenon and MRSA is not usually encountered in normal everyday life.

Normal healthy people with properly functioning immune systems will not be affected by MRSA. The problems occur specifically in hospitals, especially in e.g. maternity wards, surgical wards etc, as here the bug might be introduced deep into the body where it would not normally get to by contaminated hospital instruments etc., or in areas where patients are particularly vulnerable and their normal immune systems are unable to fight the germ, e.g. intensive care, nursing homes etc.

The Sunday Times, December 2002 stated "Hospital acquired infections are killing somebody every two hours and costing more than £1 billion a year."

The Public Health Laboratory Service (PHLS) estimates that there are now between 80,000 and 100,000 cases of MRSA infections every year (PHLS and Office of National Statistics). To put this into context, one in six patients in intensive care will contract MRSA. Of the 1,591 staphylococcal-linked deaths in 1998 at least 44% were as a direct result of the MRSA infection.

Clinical waste operatives (e.g. incinerator plant operators, carriers etc.) are not at risk from MRSA (unless they are immunocompromised) however, where customers provide notification that they have MRSA patients e.g. in nursing homes, the waste should be put through the Group A Clinical waste stream for disposal.

S. aureus

is probably the most common cause of nosocomial infections and represents a huge challenge to the medical and scientific community. For prevention of the transmission of S. aureus the most important factor remains hand washing, especially among the medical fraternity e.g. doctors and nurses.