Thursday, November 11, 2010

Focus on increasing hygiene in medical facilities or production of new "super antibiotics"?

Almost every single person has heard of the medical term MRSA infection and many have a view on how to stop it.When Paris Hilton went to jail in 2007, her parting words were not an apology for her irresponsible behaviour. Far from being embarrassed, Hilton said she was more worried about catching MRSA - and her fear is not unusual.

In the UK, when people think about going into hospital, they are more afraid of contracting MRSA than dying. As more people die than contract MRSA, how can the public's fears be explained? MRSA is a serious problem in the UK - hospital acquired infections (HAI) are a problem in most Western nations. However, the UK media have paid it much more attention. Between 1997-2007, the top six newspapers in the US published 177 articles about MRSA, compared with over 4,300 in the top six UK papers. This substantial difference helps explain why the public is so afraid. Much of the UK newspaper coverage centres around individual's stories. Tragic stories about young children or pregnant women contracting MRSA get a great deal of coverage, as do stories about celebrities such as Leslie Ash, Edwyn Collins and Claire Rayner contracting a hospital acquired infection. But the typical victims of MRSA - the elderly and the very ill - tend to be missing. Concentrating on young and relatively healthy victims encourages the public to see MRSA as something we should all be afraid of, all of the time. Television news, however, tends to ignore these more tabloid-style stories. It rarely reports MRSA, compared to newspaper coverage and when it does, it is primarily responding to government press releases.

In addition to the commonly reported story of the "tragedy of MRSA" is the "if only we cleaned hospitals better MRSA would disappear" story. Journalists berate doctors and nurses for failing to wash their hands, their white coats and their ties. Tabloids regularly send undercover journalists to report on the filthy state of local hospitals. Instead of tiring of these repetitive stories, we, the public, lap them up. The so-called dire state of UK hospitals and the problem of MRSA has come to represent the failure of the NHS, with one Daily Mail columnist renaming the NHS the 'National MRSA Service'.

The problem is, that most coverage fails to report the reams of scientific research on the causes and potential solutions to MRSA. Instead, the focus is on cleaning and poor hygiene, and on the more unusual and often untested solutions, such as bug-busting pyjamas. The question to ask is not simply 'why aren't hospitals clean?' Cleaning is part of the answer, but so is the reduction of antibiotics, which is regarded as one of the most effective ways of reducing MRSA. Increasing the number of isolation units so those with MRSA can be treated without the fear of infecting others is also part of the answer, as well as reducing bed occupancy in hospitals (eye styes). The media should reflect the whole story about MRSA. It could report how GPs should respond when patients demand antibiotics, or ask why the NHS isn't funding isolation units when research shows they reduce MRSA rates. If the media covered these stories on their front pages or on the morning news - would they help to start a different public debate? Research from Queen's Medical Centre in Nottingham recently found patients anxious and concerned about contracting MRSA in hospital. Their most frequent source of this information - the media. MRSA is a problem and should be reported, but if all the coverage is doing is making people anxious, the media need to ask itself if it is part of the problem. When the government announces rates have fallen, as they have recently, the media either fails to report them or tucks the story in the back pages. Reassuring stories might not be the most interesting for news editors, but the public deserves a more realistic picture of the problem of MRSA.

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