Hospitals will be a safer place for everyone...

Over 100,000 cases of hospital-acquired infection occur in the UK each year. The cost of these infections is measured in millions of pounds of healthcare funding, prolonged hospital stays, considerable illness and even death. Minimising rates of hospital-acquired infection is, therefore, a top priority.

At Brighton and Sussex Medical School we are looking at why infection control and antibiotics have little effect on the rates of disease. We are gathering strains of various infections, such as MRSA (methicillin-resistant Staphylococcus aureus) and Clostridium difficile, for detailed genetic analysis. Our research is looking for changes in disease that will help us suggest new approaches to control, antibiotic therapy and treatment.

Our aim is to develop a major centre of expertise in this field and lead the way in combating hospital-acquired infection, making hospitals a safer place for us all.

Leading the way in the fight against hospital-acquired infection

Hospital-acquired infection is a cause of major concern. It is estimated that one in 11 patients develops a hospital-acquired infection and over 100,000 cases occur each year in the UK. The cost of these infections is measured in millions of pounds of healthcare funding, prolonged hospital stays and considerable ill-health and indeed mortality.

During the 1990s methicillin-resistant Staphylococcus aureus (MRSA) infection was the prime focus of concern. More recently other forms of hospital-acquired infection have emerged including antibiotic-associated diarrhoea caused by Clostridium difficile, antibiotic-resistant species such as Acinetobacter baumannii and antibiotic-resistant strains such as extended spectrum beta-lactamase producers. Although unfamiliar to the public now, these terms are likely to become as infamous as MRSA.

Minimising rates of hospital-acquired infection is a top priority. Much attention has focused on infection control and appropriate antimicrobial use. We feel that changes in microbial virulence are also likely to be important. In Brighton there has been an increase in the rates and severity of S. aureus infections that can not be explained by changes in infection control or antibiotic use. In the light of this we studied our S. aureus strains and found that these had changed. We are now gathering strains for detailed genetic analysis. We are looking for markers of virulence that could explain this change in disease and suggest novel approaches to control and treatment.

Similar changes in the rate and severity of Clostridium difficile infection have occurred with devastating effect, most infamously at Stoke Mandeville Hospital and in several North American centres. At Brighton and Sussex Medical School we are beginning a study that will characterise our strains and look at how to quickly identify patients with severe disease. This is part of a trial looking at a new antibiotic therapy for Clostridium difficile infections.

These examples are typical of the sort of work we are developing. We believe that hospital-acquired infection, and the rise of antibiotic resistance, will be major challenges to medicine in the years ahead. At BSMS and Brighton and Sussex University Hospitals NHS Trust we are aiming to develop a major centre of expertise in this field and to lead the way in combating hospital-acquired infection.