The vast majority of Irish hospitals are unable to implement guidelines designed to prevent the MRSA superbug due to a lack of adequate facilities, a team of experts has concluded.

The Health Protection Surveillance Centre (HPSC) has been told by the heads of 43 out of 49 acute hospitals that they cannot follow best practice on tackling the infection for various reasons including poor infrastructure, inadequate laboratory resources and insufficient staff, isolation rooms or beds. Four hospitals did not have an educational programme on hand hygiene, and only 17 had a programme to monitor the amount of antibiotics used. The MRSA guidelines were introduced in 2005 in response to fears about the bug.

Doctors from the HPSC’s Strategy for the Control of Antimicrobial Resistance in Ireland said: “There are still major challenges in Ireland to the full implementation of national MRSA guidelines. It is of concern that 8% of the hospitals surveyed did not have educational programmes on hand hygiene.”

The research, published in Infection Control and Hospital Epidemiology, found one third of hospitals did not have a written policy on antibiotic use, and only 35% had an antibiotic stewardship programme.

Ireland has one of the highest levels of antibiotic use in Europe. Many infections such as MRSA have become resistant to antibiotics. Ireland is one of only three countries in Europe where outpatient antibiotic prescribing is increasing.

Only one of the 49 acute care hospitals believed that its infrastructure was adequate to allow full implementation of the guidelines, while three believed their laboratory resources were adequate.

Only three hospitals believed they had enough single rooms. In 88% of them, one third of the rooms were single-patient units, while only 29% had the recommended 2.9 metres of space between beds in multiple patient rooms.

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