City has highest and lowest in superbug league; MRSA crisis growing at hospital trusts in region.

Byline: LLOYD JONES and ROBERT MERRICK

A NATIONAL league table for the MRSA `superbug' has rated Liverpool's Cardiothoracic Centre worse than any other hospital in its category.

But the Liverpool Women's Hospital can boast the lowest rate of superbug infections of any hospital in its classification, according to the Department of Health.

The figures show the MRSA crisis is growing at seven hospital trusts in Merseyside and North and Mid Cheshire, but is being tackled at the remaining six.

According to the report, the Women's Hospital has the lowest infection rate of the 48 specialist hospitals in England -- 0. 067 cases per 1, 000 bed days in 2003/4, up from 0. 054 the previous year.

But the infection rate at the Cardiothoracic Centre -- 0. 281 cases per 1, 000 bed days, up from 0. 162 -- is the worst of the 21 single specialist hospitals in the country.

Jan Walters, director of nursing at the Cardiothoracic Centre, said the league tables give an unfair impression.

She said: ``We welcome reports like this that are looking at levels in MRSA rates in individual hospitals. Reports like this can be a reminder for staff and patients.

``But it doesn't show what we feel the Cardiothoracic Centre is like and not what patients know us to be like.

``We deal with many vulnerable patients and do more invasive surgery, which carries more risk.

``Also because we are a tertiary referral centre and we take referrals from the community and other hospitals a proportion of patients already have MRSA when they come here.

``You do need to compare like with like because otherwise it is not clear and not fair.

``League tables don't always show that clearly. ''

She is also worried that the figures could give the public the impression the centre is dirty.

``People who come to the Cardiothoracic Centre know it is bright and clean, patients are very positive about their experiences here and staff enjoy working here, '' she said.

``But sometimes things like this report can give a very negative picture of a place, and that is not the case. ''

Infections are also on the rise at the Children's Hospital, St Helens and Knowsley Hospitals, Wirral Hospital, Mid Cheshire Hospitals and the Royal Liverpool and Broadgreen.

But they are falling at Southport and Ormskirk, the Clatterbridge Centre, North Cheshire Hospitals, the Walton Centre for Neurology & Neurosurgery, Aintree Hospital and the Countess of Chester.

Dr Geraldine Boocock, director of infection prevention and control at Southport and Ormskirk Hospital NHS Trust, welcomed the news.

She said: ``We are pleased that the hard work, dedication and tremendous effort that all staff members make in preventing and controlling infection have been rewarded with these figures''.

Since monitoring began three years ago the trust has consistently performed well and is four times above the national average this year.

But nurse consultant for prevention and control of infection Martin Kiernan warned the trust must not become complacent.

``We must continue to implement a range of infection control measures in order to prevent cross-infection, '' he said.

``Although some patients do come into contact with MRSA, this data has demonstrated that we have been effective at preventing the most serious form of infection and we have appropriate ways of dealing with it. ''

Dr Judith Bowley added: ``In our experience, MRSA most commonly colonises patients who usually do not go on to become infected.

``When this happens our policy is to isolate the patient for the protection of others and screen other patient contacts.

``We feel this is a highly effective way of controlling MRSA. ''

Tim Neal, director of infection prevention and control at Liverpool Women's Hospital, said: ``We are very pleased with today's published figures on MRSA.

``As a three star trust, the management and staff of the hospital take the issue of infection control very seriously.

``We do however recognise that this requires constant attention and the problems that contribute to high and low infection rates are complex and it is our intention to maintain our current high standards. '' The figures were released as an independent watchdog heavily criticised the NHS for incomplete data, which meant the problem could not be accurately assessed.

The National Audit Office estimated that 5, 000 people die every year from infections such as MRSA -- but warned the true figure could be much higher. ESTERDAY, Tory leader Michael Howard said superbug deaths had doubled since Tony Blair came to power in 1997, with no progress made since an earlier NAO report four years ago. But the Prime Minister insisted the Government was taking tough measures to bring down infection ratesk. According to the NAO, if recommended measures had been brought in across the NHS in England, infections and deaths could have been cut by around 15% -- around 750 deaths a year. Its report warned that many doctors and nurses fail to wash their hands between patients -- even though this is thought to be the key factor in preventing the spread of infections.

Other factors which have pushed up infection rates include high levels of bed occupancy and a lack of side rooms, which mean infected patients cannot be isolated easily. The Government announced on Monday it was adopting further measures, including bringing in overseas experts and urging patients to complain about dirty hospitals. MRSA (methicillin resistant staphylococcus aureus) first appeared in the 1960s. Some strains are resistant to almost all known antibiotics and efforts to combat it cost the NHS pounds 1bn a year. Treatment undergoing trials

TRIALS are taking place on a possible treatment for MRSA, developed by a Warrington firm. Biotech company Micap has combined antiseptic oil with biocides and found it can kill several strains of MRSA in the lab. Now a clinical trial is taking place in the burns unit of Wythenshaw Hospital in Manchester, where the biocide will be placed in the skin dressing of infected patients. Around 40 patients attending burns clinics are taking part in the trials. MRSA often becomes resistant to the biocides used against it by hospitals, but Micap has found its mix of technologies has been more effective.

CAPTION(S):

Squalid looking conditions in a room used the house cleaning material at Fazakerley Hospital. Tables showing how region's hospitals and Liverpool Women's Hospital came out on top in its classification; Liverpool's Cardiothoracic Centre was found to be worse than any other hospital in its category; Jan Walters