Malta’s hospital has managed to cut by a third its infections from MRSA, the superbug resistant to antibiotics, using a simple testing method that could change the way other hospitals in the Mediterranean and Middle East deal with the problem.
MRSA bacteria could lead to complications such as heart failure and paralysis and could even be fatal.
Mater Dei Hospital has been testing all newly admitted patients using a simple procedure that has improved patients’ quality of life at minimal expense, saving the authorities thousands of euros, Head of Infection Control Michael Borg told Times of Malta.
Prof. Borg was commenting about the findings of local research published in the English Journal of Hospital Infection. The paper, called “Universal admission screening: a potential game-changer in hospitals with high prevalence of MRSA”, is one of a handful of papers worldwide illustrating the socio-economic impact of a preventative measure implemented by a hospital.
It turned out that for every €1,058 invested in MRSA testing, an MDH patient gained a full year of good quality life, known as QALY (quality-adjusted life year).
This is a universal measurement used by hospitals to decide whether a medical intervention is cost-effective. By comparison, in the UK, if an intervention costs up to £30,000 per one year of quality life, then that service is deemed cost-effective.
Malta has one of the highest economic burdens of antimicrobial resistance in Europe. In 2019, the Organisation for Economic Co-operation and Development had reported that the island spends more than €3 million per year on such infections.
Over six years the prevalence of MRSA in hospital dropped by more than a third
Throughout the 1990s and 2000s, Malta consistently ranked as one of the top two EU countries for MRSA prevalence in hospitals. The superbug is also prevalent in the community because of the high use of antibiotics among the Maltese, with at least two out of five people taking the treatment without needing to.
Up until six years ago, only admitted patients showing symptoms of an MRSA infection would get tested and eventually treated, as is common practice in most hospitals worldwide.
But in 2014, the infection control department adopted a protocol through which, every day, two care assistants would swab all new admissions, across all hospital wards. The lab result is then out within a couple of minutes.
Swabbing increased tenfold, reaching 99 per cent of all hospital admissions.
“MRSA spreads quickly in hospitals as asymptomatic patients with traces of the bacteria on their skin could contaminate surfaces touched by other patients. Bacteria could also spread to patients’ blood during simple procedures such as venflon intubation,” Borg explained.
“We managed to stop the vicious cycle by identifying carriers from the get-go and treating people for MRSA before it spreads or develops into a serious infection.
“The impact was immediate, and over six years the prevalence of MRSA in hospital dropped by more than a third.”
Apart from improved quality of life, he said, there was a reduction in costs linked to the treatment of MRSA infections.
“Patients being treated for MRSA infections need to stay in hospital for an additional five to eight days, with treatment potentially costing hundreds of euros per day. This means, that before even taking into account the lives that were saved and the improvement in quality of life, the swabbing expenses are potentially recovered in this manner,” he said.
The other authors were David Suda, Elizabeth Scicluna, Andre Brincat and Peter Zarb.