Terence Kealey
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Last Thursday the Office for National Statistics confirmed that more than 20 patients a day now die from the superbug infections, MRSA and C difficile.
NHS practice has been poor. MRSA (methicillin-resistant staphylococcal aureus) is a bacterium that many people carry, safely, in their noses. Yet when people are weakened by sickness, MRSA can invade the bloodstream and kill. In Scandinavia, Holland and Harley Street (three places where MRSA is rare) carriers are screened and treated before being admitted to the wards, but the NHS has been slow in following suit.
Clostridium difficile is another bacterium that many people carry safely (in their intestines), but when hospital toilets are poorly cleaned, when wards are overcrowded, or when people fail to wash their hands, patients will acquire C difficile from each other and, in their weakened state, die of diarrhoea.
Can science offer a technological solution to the NHS's failings? Can we invent new antibiotics? Two papers offer hope.
Our bodies make their own natural antibiotics, of which nitric oxide is one. In a recent paper in Science, Dr Fang of the University of Washington, Seattle, showed that MRSA produces a special enzyme that detoxifies nitric oxide. That is why MRSA can kill us.
Meanwhile Dr Pierik of Philipps University, Marburg, has shown that C difficile's enzymes are equally special. They are ancient. There is no oxygen within our guts because the bloodstream does not extend into them. But billions of years ago - before green plants evolved - there was no oxygen in the Earth's atmosphere either. Yet bacteria were already established, and C difficile still uses the enzymes of its primordial ancestors to flourish without oxygen.
Antibiotics work as “magic bullets”. It was Paul Ehrlich, the German microbiologist, who in 1909 invented antibiotics by identifying chemicals that, magically, disabled bacterial but not human enzymes. But to find his bullets, Ehrlich had to search randomly. He infected rabbits with syphilis and he dosed them with random chemicals. He named his first drug Salvarsan 606 because it was the 606th chemical he tested that finally cured the rabbits.
Drs Fang and Pierik now proffer the hope of a focused future. Now that we can characterise the key enzymes of MRSA and C difficile, we might design new antibiotics systematically, not randomly. Science may indeed rescue us from the NHS's failings.
Yet the NHS, as a state monopoly, will find new ways to fail. And we will have ourselves to blame. The insurance-based systems of continental Europe - whose hospitals have bed occupancy rates of only 75 per cent and whose hospitals, being separately owned, compete for patients - are better than our own. But the British resist reforms that cost them money.
Terence Kealey is the Vice-Chancellor of the University of Buckingham
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"2 words: Socialized. Medicine." - James, NJ, USA
MRSA caused 19,000 US deaths in 2005 ('Invasive Methicillin-Resistant Staphylococcus aureus Infections in the United States', CDC, 2007)
Some quick maths suggests that's half the UK 2008 death-rate intimated above. But still nothing to brag about.
Tom Fox, London, UK
Please Note
To the writer of the Japan Elevator Story
Arthur C Clarke First fictionalised this concept; a Leningrad engineer, Yuri Artsutanov, however first developed the concept in detail in 1960 and later by several American engineers quite unaware of Artsutanov's work.
Colin, Melbourne, Australia
I may be naive, but surely much of the damawge of these terrible infections could be avoided by every day and frequent hand, bed, bed linen, towelling, toilet and floor cleaning with old fashioned soap and water? Possibly with the addition of a disinfectant pad on the floor of every ward?
helen, Norwich,
Why doesn't Labor simply outlaw the bacteria and forbid it to reproduce in NHS facilities? Isn't that how every other problem is "solved" in the Once Great Britain?
Richard Z, Woodbridge, NJ, USA
The solution has been there all along: phage therapy. It works on all strains of S. aureus, used safely for the past 60 years in Georgia. Google and watch the BBC2 documentary called "The Virus that Cures".
Tsiala Namgaladze, San Francisco, CA, USA
The big question is where is the vaccine against hospital staff? Development of such a vaccine should be a major priority. Its use should be required for anyone who works in or is a hospital patient.
William Brand, Humble TX, USA
One recalls that in the 'bad old days' the hospital wards were run military style by domineering matrons who wouldn't tolerate the unhygienic activities of the anarchic hospitals of today .
Young graduating nurses have no idea of who Florence Nightingale was.
Homeopaths remedying anything? A joke?
Dr Andris Lielmanis, Brampton, Canada.
People, your cleaners / nurses come from Africa, where most of them have not even seen running water! For them anything not obviously dirty is clean and that is it, what do you expect?!
Swedish hospitals are cleaned by Sweeds...
On top of that the English themselves are not very hygienic too.
Swen Janssen, London, UK
Quiet desperation indeed.
Our stay in a British maternity ward was very revealing. Visitors to intensive care ward coughing near new born babies, no one washing hands properly, staff without the backbone to stand up to it - "what can we do?" etc. How hard can it BE to have a culture of cleanliness??
charlie/ expat, los angeles, US
Its the medical profession with its over reliance on antibiotics, prescribing them in many cases where they have no proof of requirement, that have led us to a weakening of the imune system and a resistance to treatment. Its not disease we should be fearful of, its blind science that will kill us.
Rick Armstrong, Leeds,
I'm taking a stand against medicine now. Unless it is combined with eugenics it merely weakens the species. This is why pathetic infections like measles are becoming deadly.
Birds in Nature suffer a 70% mortality thus ensuring the health of the species, humans need to study nature more.
keith bentham, wigan, uk
James: who pays your insurance? Do you really think that you get your money's worth, as much of the cost of health care in the US is swallowed up by administration.
As for MRSA many NHS hospitals routinely swab for it on admission, as many people have already been colonised by the bacterium.
Dectora, London, UK
MRSA can be beaten. If something will not heal up, salted water on the wound, followed by a bit of direct sunlight will heal it up. I have seen the results 3 times. This was passed on by the various doctors involved.
margie , victoria, australia
Try using ClO2, chlorine dioxide. can be taken internally and will destroy every know pathogen. google MMS, man cures 75,000 cases of malaria in 4 hrs. Used over 100 yrs for sterilizing hospitals and drinking systems but never tried internally. I have taken the max suggested dosage, no harm done.
Stephen Forbush, Santa Cruz, United States
2 words: Socialized. Medicine.
You Brits get what you deserve, and what you voted for: high taxes, rationing, waiting times, poor service, pointless beaurocracy. It will only get worse as time goes by, mark my words.
Can you believe many of my countrymen want to take us down the same road?
James, Asbury Park, New Jersey, USA
There is nothing wrong with the NHS in principle, but when it was set up the entire issue of public heatlh, hygene, diet and lifestyle was ignored. The answer to health problems was seen as a pill or vaccine. This is still the case and will put the NHS beyond affordability until the focus changes
Dr J. Poole, Romsey, UK
My mother was recently in a UK hospital ward. At the entrance there were excellent washing facilities, alcohol hand gel, paper towels etc. I sat beside these facilities waiting to see the ward sister and was able to observe the people entering and leaving the ward. In the space of 15 minutes at least 50 people entered or left and not one - I repeat, not one - washed their hands or used the alcohol gel. That, for me, was a clear statement of the cause of the hospital infection problem. Thoughtlessness, laziness, stupidity or a combination of the three.
gonzales, Leicester, UK
The problem with antibiotics is they are so misused by doctors who give them to ensure 'patient satisfaction' that it just breeds resistance in microbes. What's the point in big pharma investing millions when 5-20 years time there will be resistance proliferating? Cost : Benefit just isn't worth it.
peter w, york, uk
Malcom - most previous drugs to circa 1990 were based on natural compounds. Modern drugs are mostly synthetic compounds which are considerably more expensive to bring to market, and have much higher failure rates in testing.
As for things like MRSA... Phages.
Leon Wolfeson, Oxford, UK
My company Nature Best products, LLC , is currently developing some products from BRAZILIAN RED-PROPOLIS.
The antimicrobial activity against S. aureus ATCC 25923 and S. mutans UA159 was evaluated and the chloroform fraction (Chlo-fr) was the most active with lower MIC ranging from 25 to 50 µg.
Dalmo Accorsini, Hallandale, USA
Here in Switzerland there's no mention of MRSA. Once a patient is finished, the entire bed is taken down to the basement, stripped and cleaned. A fresh bed is put into its place ready for the next patient. Also, all hospital staff wear uniform, white scrubs or polo shirts from the in-house laundry.
Sarah, Zurich, Switzerland
Second point: A small plastic gripping device or "key" to be manufactured for less than 25 cents and issued to everyone who enters the hospital, to open doors, operate taps etc, and discarded (to be incinerated when leaving). This would promote a culture of aseptic contact within the hospital.
David Chorley, Tulsa, Oklahoma USA
No antibiotics are needed, just simple hygiene will suffice. Hygiene is the reason Holland and presumably Sweden steer clear of increased infections despite increased carriers from e.g. India, Eastern Europe. Hygiene costs a lot less and no resistance to hygiene has ever developed.
Nick, London,
'Hanging on, in quiet desparation is the Englsih way'
Eddie Reader, birmingham, england
All the big pharma drug pipelines are running dry. Either there are no molecules left to discover, or something is badly wrong with our basic science.
Malcolm McLean, Bradford, UK
The NHS funds several homoeopathic hospitals: surely they can come up with a 'remedy' that will obliterate MRSA?
Alan Henness, GLASGOW,