Hospital Acquired Infections or Healthcare Associated Infections are defined as infections not present and without evidence of incubation at the time of admission to a healthcare setting.

Within hours after admission, a patient's flora begins to acquire characteristics of the surrounding bacterial pool. Most infections that become clinically evident after 48 hours of hospitalisation are considered hospital-acquired. Infections that occur after the patient is discharged from the hospital can be considered healthcare-associated if the organisms were acquired during the hospital stay.

There are a number of causes of Hospital Acquired Infections. When a patient's bed and surrounding area have not been vacant long enough for proper cleaning due to hospital staff being under pressure to meet increasing targets, the risk of contracting such an infection is dramatically increased. In addition, a lengthy stay in a healthcare setting makes patients more vulnerable to infection and large wards with a stream of emergency admittances make it difficult for wards to be thoroughly cleaned. Improper hygienic procedures (failure to thoroughly wash hands with hand gels, failure to properly sterilise equipment, failure to wear gloves when necessary, and failure to properly clean towels and bed sheets etc.) can result in a negligently acquired infection.

MRSA (Methicillin Resistant Staphylococcus Aureus) is a form of bacteria from the Staphylococcus Aureus family. These bacteria can live on the skin’s surface or inside the nose of a large percentage of the population without causing harm. However, if people become infected with these bacteria through a cut or wound, septicaemia, pneumonia, endocarditis, skin, bone, and joint infections can all occur. MRSA is resistant to the antibiotic Methicillin, which also results in resistance to Flucloxacillin and Cephalosporins, which represents the usual treatment. There is only a restricted choice of effective antibiotics to which MRSA is susceptible, such as Vancomycin or Teicoplanin.

It is recognised that the principle mode of spread of MRSA is from person to person, usually via the hands, and it can also be passed through contact with objects in the environment carrying the bacteria such as towels, door handles, sheets, and taps. Acquisition by this route is potentially preventable by the implementation of appropriate hygiene procedures. The other mode of acquisition of MRSA is through the airborne route and it should be noted that patients may acquire MRSA in their nose and then spread may occur to the skin sites and the wound from this patient source. This is sometimes referred to as endogenous infection referring to acquisition from the patient’s own flora. Airborne acquisition of MRSA is not readily preventable by standard infection control precautions and does not imply any lapse in the standard of care.

We have been consulted by many clients seeking to investigate whether infections acquired in hospitals were due to substandard treatment, hygienic procedures, and post operative aftercare. Whilst often these are difficult cases to prove given that infections can be acquired without any deficiency in care, Augustus Cullen Law achieved the first MRSA compensation payout in Irish History in circumstances where the infection was acquired due to a healthcare worker not wearing gloves: View full article

It is important to note that each patient is well within their rights to request an MRSA swab upon admission to hospital and prior to any surgical procedure, and note should be taken of whether appropriate hygienic procedures are in place such as healthcare workers wearing gloves. These factors are extremely important in mounting any successful claim.

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Michael Boylan

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