Source of killer bug may never be known

MEDICAL experts at Ipswich Hospital last night admitted the cause and source of baby Luke Day's MRSA infection might never be discovered.

They were speaking after a detailed investigation into how 36-hour-old Luke contracted the bug and why it tragically ended his life failed to provide any explanations.

In an interview with the East Anglian Daily Times, Dr Phillip Jones, consultant microbiologist at the hospital, said more than 60 members of staff working in the maternity unit had been swabbed to see whether they carried MRSA in their noses or hands.

A further 100 swabs were also taken from equipment that Luke and his mother might have come into contact with, also from cots, resuscitation facilities and the ward environment - however no signs of MRSA were present.

Dr Jones said: "We examined all the procedures that Luke and his mother had when they came into the hospital and did not find anything amiss there.

"We looked very carefully at the environment both where Luke was born and where he stayed the next day.

"Yesterday I spoke to two people who are experts in this field and they said we have done everything we could do. We do not know how the organism infected Luke and we don't know why he died so quickly without any sign because that's not the way with MRSA when infection occurs. There is usually a period of ill health and definite signs of infection.

"We understand the distress this has caused to Luke's family. We understand the uncertainty this gives people but we can only be honest - we do not know."

Dr Jones said the MRSA present within Luke had been sent to a specialist MRSA reference laboratory in London.

Their initial report had failed to find anything remarkable about the strain he had been infected with and it was not particularly virulent. Further work is likely to continue.

Annie Newton, senior infection control nurse, added: "We know there was no gross breach of practice. When you do not get any answers where do you turn to? The only thing we can do is make as many people aware of this situation as possible and continue to promote best practice and continue in our efforts to maintain the standards we have already got.

"We may never know. We have looked very, very hard and sometimes you do not (get answers)."

Dr Jones said MRSA was not endemic in the hospital's maternity unit, and said the unit had seen fewer than five mothers in the past year who had MRSA.

"MRSA is not an inherent problem in that unit which is why Luke's death is such a shock. It's a sporadic event and we have not had any similar infections or problems before Luke and there hasn't been any since," he said.

"We actually feel in general we have MRSA under control in that unit. We cannot say another sporadic event will not happen at some point. We have never had a case like it before at Ipswich Hospital. I hope we never have one again."

But while Dr Jones said MRSA was not an inherent problem in the maternity unit, he added that like many other hospitals, it was endemic elsewhere in the hospital.

The hospital has an active screening programme for various patients coming into the hospital and typically undertakes 12,000 MRSA swabs on patients every year.

These patients could be coming into the orthopaedic wards, haematology, or in intensive care.

Where possible, the hospital isolates patients with MRSA however with occupancy rates of 95%, these beds are sometimes unavailable. In that event, everything possible is undertaken to minimise its spread.

"Our duty is to contain it by using anti-septic and body washes to try and rid them of their strain so as not to cause them infection," said Ms Newton.

Ms Newton said cleaning standards had improved over the last two years and infection control nurses had put a lot of effort into maintaining cleaning standards.

"We do have an improvement generally in ward cleanliness since we have introduced the role of the housekeeper. We have currently got about 10 housekeepers in post. The intention is to increase those numbers when we get the resources," she said.

"Modern matrons have been an asset as part of their role is to look at quality of care and that includes ward cleanliness. They have interest and responsibility for infection control in the ward area.

"We have always been very keen on point hygiene, using alcohol point rub for many years and introducing a gel about four or five years ago."

The hospital is also using a new micro-fibre cleaning method, which has previously been trialled in other hospitals.

Dr Jones said staff were much more aware of MRSA and there would be extreme vigilance in the maternity unit following Luke's death.