EU told to do more to fight hospital bugs

The EU needs Europe-wide standards on hospital cleanliness and hygiene to combat increasing levels of antibiotic resistance, according to the head of the European Centre for Disease Prevention and Control (ECDC).

The comments from Zsuzsanna Jakab, the Hungarian-born director of the ECDC, come as the European Commission prepares a recommendation on healthcare associated infections, for publication in autumn 2008.

The ECDC estimates that three million people in the EU catch a hospital infection, every year, and that about 50,000 of them die.

"This is first of all a hygiene issue," said Jakab. "You would be surprised to see that there are still countries in the EU where medical staff only wash their hands between 30% of medical interventions," she said.

"We should start with basic hygiene standards and for this we need EU guidelines. A recommendation is a good start, but we will need more." The ECDC director said that this was "a serious issue" requiring serious work.

The Commission recommendation will also look at whether member states are following existing advice on the ‘prudent use of antibiotics’ from a 2001 communication.

It is thought that in some countries, particularly in southern Europe, it is still possible to buy antibiotics without a prescription.

Antibiotic resistance can develop through the overuse of antibiotic drugs, or through inappropriate cleaning procedures. In hospitals and healthcare centres this has led to the spread of drug-resistant microbes such as methicillin-resistant staphylococcus aureus (MRSA).

But consumer demand is also pushing up the use of antibiotics, according to Jakab. "Sometimes prescription habits need to be examined," she said. "And sometimes it is the patients’ habits: some people feel they should be able to keep antibiotics at home in case they are ill."

The ECDC is currently visiting member states to monitor the situation with antibiotic resistance and hospital infections, before the Commission recommendation is published. Their action follows a June ECDC report that labelled healthcare infections "possibly the biggest infectious disease challenge facing the EU".

Jakab said that it was too early to draw conclusions from the member states assessed so far, but that there seemed to be a link between countries where antibiotic use had fallen and countries suffering from the lowest rates of hospital infections.

She praised France for a recent review of "hospital hygiene and attitudes to antibiotic prescription", which helped make it one of only two countries, along with Slovenia, experiencing a fall in the number of MRSA infections. The UK and Romania were among countries with the highest MRSA rates.

The UK last month announced new hospital cleanliness measures to tackle MRSA, including the creation of a new hospital regulator with powers to impose fines and close down entire wards in hospitals that do not meet hygiene requirements.

A UK diplomat warned against rushing EU action, saying that it was important to see what could be done through national action first.

A Slovenian diplomat said that MRSA rates had been brought down in her country though a strict training programme for hospital staff, introduced in 2003. The programme includes training on how to wash and disinfect hands properly.

She said that it was important to look at what all member states were doing to tackle the problem and share best practices.

Jakab said that as well as identifying best practices, the ECDC wanted to raise consumer understanding of antibiotic resistance. Next Tuesday (16 October) Jakab and UK centre-right MEP John Bowis, together with Commission officials and national experts, will host a debate in the European Parliament on raising public awareness about antibiotic resistance.

An EU-wide antibiotic awareness day will take place for the first time in the autumn of next year.

The EU needs Europe-wide standards on hospital cleanliness and hygiene to combat increasing levels of antibiotic resistance, according to the head of the European Centre for Disease Prevention and Control (ECDC).