The board of Beaumont Hospital in Dublin, which finished at the bottom of the Government's national hygiene audit this week, was warned by its internal infection control committee last July that up to 330 patients had acquired the MRSA superbug in the hospital last year and that there were major problems in preventing the condition arising.
A report submitted to the board by the chairman of the committee, Prof Hilary Humphreys, criticised a lack of isolation facilities and the hygiene practices of some staff. It revealed that, at some stages last year, 15 per cent of patients with MRSA had to be cared for in open wards against international best practice because of a shortage of single rooms and pressure on beds.
The report, seen by The Irish Times, warned the board that there was "a serious cause of concern at the number of MRSA patients, some with serious or even fatal infections, arising from the increasing pressures on our facilities and personnel".
The report said about one quarter of those observed entering isolation rooms were not wearing protective clothing.
"The infection control nurses and consultant microbiologists have a proactive approach to the control of MRSA but we are hampered by the lack of isolation facilities, the large number of complex patients in this hospital and deficiencies in compliance with best practice by some hospital staff," Prof Humphreys said.
The report said an internal audit of hand hygiene had highlighted over-use of gloves, a lack of hand hygiene after glove removal and the absence of hands-free mixer taps.
"During 2004, we calculate that approximately 330 patients were identified with MRSA 48 hours or more after admission to hospital. Forty-eight hours or more after admission is generally taken as an indication of acquisition in that institution compared with acquisition before admission either in the community or elsewhere," the report said.
A spokesman for Beaumont confirmed last night that up to 330 patients could have acquired MRSA last year. He said two-thirds of these were carriers of the bacterium. The remainder had a range of infections. He said up to 45 patients who contracted MRSA could have developed bloodstream infections.
The spokesman said the report was part of an ongoing attempt to identify and deal with problems.
Beaumont had previously refused to release details on MRSA rates in the hospital.
The governance and services committee of the board maintained in a separate report that hand hygiene was an issue of serious concern. It said: "One of the main factors which affects Beaumont Hospital in the control of infection is the rate of occupancy, which is constantly in the region of 100 per cent."
