The strategy for the control of antimicrobial resistance in Ireland, SARI, was launched in June 2001. Approximately €16 million in funding has been made available to health boards since then — of which €4.5 million was provided in the current year — to implement the strategy. Much of this funding is designated for improving hospital infrastructure for control of infection and for appointing the additional microbiologists, infection control nurses and other health care professionals required for effective control of infection in hospitals.
MRSA infection is generally confined to hospitals and, in particular, to vulnerable or debilitated patients including those in intensive care units, on surgical, burns or orthopaedic wards, elderly and-or very sick patients and those who have open wounds, etc. Carriage of MRSA does not generally pose a risk to family members — unless they are suffering from a debilitating disease — or hospital staff of an affected patient or their close social or work contacts. MRSA does not harm healthy people, including pregnant women, children or babies. MRSA can affect people who have certain long-term health problems. Visitors to patients with MRSA infection should be advised by the local nursing-medical staff to wash their hands thoroughly after visiting patients so as to avoid spreading MRSA.
Infection with staphylococcus aureus or MRSA bacteria can be prevented by practising good hygiene as follows: keeping hands clean by washing thoroughly with soap and water; keeping cuts and abrasions clean and covered with a proper dressing — a bandage — until healed; and avoiding contact with other people's wounds or material contaminated by wounds.
While financial assistance as such is not given, assistance is given to patients and their families by way of advice. Both patients and families of patients who contract MRSA should ensure they practise good hygiene standards. Hand hygiene is a key component in the control of MRSA and the SARI infection control sub-committee has recently released national guidelines for hand hygiene in health care settings. These guidelines have been widely circulated by the NDSC and are available on the its website,www.ndsc.ie. Each health board — authority region has a regional SARI committee and these are responsible for regional interventions to control hospital infection, including MRSA.
In 1995 my Department prepared a set of guidelines in respect of MRSA which have been widely circulated and include an information leaflet for patients. The SARI infection control sub-committee is currently updating national guidelines on the control of MRSA in health care settings. A draft version of these guidelines will be distributed for consultation shortly and will also be available on the NDSC website. The key recommendations cover such areas as environmental cleanliness and overcrowding, sufficient isolation facilities, hand hygiene, appropriate antibiotic use, early detection of MRSA through surveillance and laboratory detection of MRSA.
Senior hospital and health board managers have corporate responsibility for ensuring that appropriate infection control measures are implemented.