Superbugs - The Facts

What does the term ‘superbug’ mean?

‘Superbug’ is a term commonly used to describe the antibiotic resistant strains of pathogens.
Some pathogens are intrinsically resistant to particular antibiotics, and others are learning
how to be. Since antibiotics became widely used during World War II, they have helped save
countless people from disease and infection, but over time, some pathogens have developed
ways to resist the effects of antibiotics. Widespread use of antibiotics is thought to have
encouraged evolutionary changes in bacteria and viruses that allow them to survive treatment
with antibiotics and can make some infections very hard to treat in humans.

Who is at risk from superbugs?

We often hear about people contracting infections from ‘superbugs’ when they are in hospital.
This is because people in hospitals are already immunocompromised, and vulnerable to
infections. However, you don’t have to be in hospital to be immunocompromised, many
people suffering from long term illnesses or recovering from serious illnesses at home will be
more vulnerable than healthy people to infection. Older people and young babies also have
weaker immune systems.

The organism Staphylococcus aureus is found on many individual’s skin and seems to cause
no major problems. However if it gets inside the body, for instance under the skin or into the
lungs, it can cause important infections such as boils or pneumonia. Individuals who carry this
organism are usually totally healthy, have no problems whatever and are considered simply to
be carriers of the organism.

Individuals can become carriers of MRSA in the same way that they can become a carrier of
ordinary Staphylococcus aureus which is by physical contact with the organism. If the
organism is on the skin then it can be passed around by physical contact. If the organism is in
the nose or is associated with the lungs rather than the skin then it may be passed around by
droplet spread from the mouth and nose.

Should we be worried?

Because people whose immune systems are compromised are most likely to suffer from
infection by a superbug, there is no cause for mass panic. However, it’s important to maintain
a good level of hygiene in the times, places and situations that really matter to prevent being
infected by a superbug. You need to take extra care if someone in your home is suffering or
recovering from an illness, is older or has just had a baby.

It’s also important that you take care when visiting vulnerable people in hospitals or nursing
homes, as you might carry a ‘superbug’ on you without having any symptoms yourself. In
fact it’s estimated that one in three healthy people carry Staphylococcus aureus (of which
MRSA is the antibiotic resistant strain) on their skin, in their nose or in the back of their
throats.1,2

Superbugs have been hitting the headlines recently – find out more about some of the more
famous ones below…

Methycillin-Resistant Staphylococcus aureus (MRSA)

Staphylococcous aureus is a bacteria that is commonly found on human skin and nose and mouth lining. It can live harmlessly on humans, however if it enters the body through a cut or wound it can cause serious infection.
Symptoms include boils and abscesses, and if it spreads further into the body, it can cause blood poisoning.
MRSA stands for varieties of Staphylococcus aureus that are resistant to methicillin and some other antibiotics used to treat it.
MRSA is one of the most prevalent micro organisms linked to healthcare associated infections around the world. Infections usually occur in hospitals to vulnerable or debilitated patients.
MRSA strains were first seen in the 1960s and new strains have continued to appear, the most recent strains developing during the 1990s. MRSA prevalence in healthcare institutions has highlighted the need for tough hygiene regulations within these institutions and within the community.
Thorough hand washing and targeted hygiene can help prevent the spread of MRSA, as it can easily be spread by hand contact. MRSA infections that have been picked up in a community setting, which means in a previously healthy individual who has no reconised risk factors such as surgical procedures or prolonged antibiotic treatment, is referred to as C-MRSA.
Some cases of C-MRSA can produce a toxin called PVL which itself can affect the white blood cells.

Clostridium difficile (C.difficile)

C.difficile is a spore-forming bacteria which is present in the gut of most infants and up to 3% of healthy adults3, where it rarely causes problematic symptoms.
C.difficile can cause infection when the normal balance of bacteria in the gut is disturbed, in patients who have been taking antibiotics.
C. difficile can be spread from person to person because sufferers will excrete C.difficile spores in their faeces, which can survive in the environment of be passed on by contact with infected hands or surfaces such as door handles, toilets etc.
C.difficile can cause diarrhoea from mild to severe cases, and it can even cause inflammation of the bowel. It can also cause nausea, fever, loss of appetite and abdominal pain.
C.difficile can be treated, but specific antibiotics must be used and 20-30% of patients suffer from a relapse after treatment. Other treatments, such as probiotics can help to re-establish the balance of bacteria in the gut.

What precautions can I take?

There are simple steps you can take to help prevent yourself from either becoming infected with a superbug, or spreading it to others who may become infected.

These include:

If you are visiting someone in hospital or a nursing home, who may be ill or recovering from an illness, make sure you wash your hands before going to the hospital, particularly if you are going to have contact with the patient.
Remember, you can be carrying a superbug without knowing it. To prevent infection, make sure you always wear a clean plaster or dressing over fresh cuts and wounds, particularly if you are going to hospitals, nursing homes, swimming pools or gyms, where you find high numbers of visitors.
To prevent cross contamination in the wider community, make sure you wash your hands when you leave hospitals and nursing homes.
Within your home, make sure you focus you cleaning efforts where they make the difference, in the times, places and situations that will help to reduce risk of cross contamination and infection.

A few tips to help you make the most of targeted cleaning are:

Think about how germs can enter your home such as on people, pets or food.
Understand how germs travel around your home, by frequently touched surfaces like door handles and light switches, or on damp surfaces where germs love to breed such as damp dishcloths.
Take extra care to disinfect the hotspots in your home if there is someone in your house who is elderly, very young or unwell.
Remove the chance of germs being passed from person to person by using a disinfectant, such as bleach, to ensure all surfaces are hygienically clean

Health Protection Agency, MRSA information for patients. www.hpa.org.uk
Association of Medical Microbiologists – the facts about MRSA. www.ammco.uk
Health Protection Agency Questions and Answers – Clostridium difficile. www.hpa.org.uk
Department of Health. www.doh.gov.uk