Bacteria will be present in hospitals as long as people are, but vital lessons in infection control have been learnt since outbreaks of Clostridium difficile caused the death of at least 90 patients at Maidstone and Tunbridge Wells NHS Trust in Kent.

Sara Mumford, formerly of the Health Protection Agency, the watchdog for infectious diseases, helped to bring attention to how much bad hygiene and poor staffing had contributed to hundreds of infections during the outbreaks of 2005 and 2006, which were later the subject of a high-profile investigation by the Healthcare Commission.

Now the director of infection control at the trust, Dr Mumford has an array of tools and procedures to keep superbugs at bay, she told The Times yesterday.

“Unlike MRSA, there is no way of screening for C. difficile, so the most important thing to get right is cleanliness,” she said. “Patients, staff and visitors can carry the bacteria into a hospital without knowing it, or become infected in the community. That’s why handwashing is so important.”

After an infection had been identified, soap and water were not enough, she said. “We use chlorine-based cleaners and have antimicrobial disposable curtains that we remove after an infected patient has been in a ward. During the ‘deep clean’ we evacuated every ward and subjected everything to ultra-sonic baths or other cleaning.

“It was so thorough that afterwards the wheels on the beds seized up – they would not run properly because they’d been cleaned of oil.

“The most important thing when you suspect an infection is to isolate the patient quickly – even before you get the test results back from the lab,” she said.

The isolation facility at Maidstone – introduced only after the notorious outbreaks – is a dedicated 12-bed ward. Dr Mumford said it helped recovery if patients with the same condition could talk to each other. Patients with a C. difficile infection required specialist nursing and treatment, she said, because other factors could also cause avoidable illness.

“Antibiotic use in particular is really, really important,” Dr Mumford said. “If you give patients broad-spectrum antibiotics designed to kill all bacteria, they get rid of even the types that help keep C. difficile at bay.”

The three hospitals run by Maidstone and Tunbridge Wells Trust are now reporting rates of C. difficile that are below the national average.

“Maidstone has had a tragic wake-up call and had to undertake a crash-course in infection control, but some trusts still have work to do – it’s something that they ignore at their peril,” Dr Mumford said.

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