Today is a good day to look ahead to some positive developments in the field of medicine for 2015.
It’s not that long ago that MRSA and other healthcare associated infections (HCAIs) were seen as a huge threat to hospitals and patients. But thanks to positive action, including campaigns exhorting handwashing and a more cautious use of antibiotics, infection levels have fallen significantly.
For MRSA, the drop has been huge at 62 per cent, while for Clostridium difficile infection, between 2008 and 2013, there has been a significant drop of 14 per cent.
Since national hand-hygiene compliance audits started in 2011, the number of staff complying with hand-hygiene procedures has increased by 14.5 per cent to the end of June this year.
HSE performance metrics measure the rates of infection per bed days. For both MRSA and C.diff, the rates have come in better than targeted. The number of MRSA bloodstream infections across the public and private hospital sector for the past eight years has dropped from 592 to 222 cases, a decrease of over 62 per cent.
Figures to date indicate that C.diff rates in the second quarter of 2014 per 10,000 bed days used have decreased by 15 per cent compared with the rate reported during the same period in 2013. And there is every reason to expect this downward trend to continue during 2015.
Tribute
The improvement is a tribute to the work of Dr Philip Crowley, HSE national director of quality improvement and his team.
“The very welcome downward trend in MRSA and C.diff infections shows how surveillance of infections has helped to drive improvement for patients,” he notes.
“The HSE has identified three priority areas for improvement: hand hygiene, medical device- related infections, and safe/appropriate use of antibiotics.”
Of course, antimicrobial resistance remains a problem. A recent European Commission report estimated that drug-resistant bacteria is now responsible for about 25,000 human deaths per annum in the EU alone, with associated healthcare costs and productivity losses of €1.5 billion.
However, it’s nice to be able to report on a positive development in the Irish health service – one with the potential for further improvement in 2015.
3D technology has a huge role to play in the future of medicine. In May, a team of surgeons from the Netherlands carried out the world's first skull transplant using a plastic tailormade 3D-printed piece.
The recipient of the printed skull was a 22-year-old woman suffering from a condition that thickened the bone structure on the skull.
This increased the pressure on her brain and was threatening her sight.
Exact fit
Explaining how in the past they created an implant by hand in the operating theatre using cement, Dr Bon Verweij, leader of the team at University Medical Center in
Utrecht
, said: “Now we can use 3D printing to ensure that these components are an exact fit. This has major advantages, not only cosmetically, but also because patients often have better brain function compared with the old method.”
Following the operation, the patient regained her vision and was able to return to work.
We can expect to see more examples in 2015 of 3D printing used to manufacture certain body parts and achieving an accuracy unobtainable by even the most skilled operator.
Finally, I’d like to thank the many readers who got in touch with their personal remedies to the problem of swallowing tablets and capsules.
From “sucking” water from a glass to taking a spoonful of marmalade, readers added many options to the two methods described in the original column.
One reader who grapples with a daily tablet which, he says, is almost 2cm long, has the following solution: “Put tablet in mouth. Fill mouth with yoghurt. Swallow the yoghurt. Tablet disappears.”
I’d like to wish all of you a peaceful and healthy new year.
mhouston@irishtimes.com muirishouston.com
