Cecilia Keaveney (Fianna Fail)

I thank the Cathaoirleach for allowing me to raise this most important issue. I raise the issue of MRSA not to indict hospitals or, in this case, dentists, but just to flag the issue and request some information. I do it with no intention other than this. I thank the Minister of State, Deputy Haughey, for being here to respond.

Coinciding with my decision to ask about MRSA auditing in dentists, we went through quite a traumatic experience locally in Donegal in which babies were diagnosed with MRSA in Letterkenny General Hospital. This links to what I was going to say. It can be seen that a number of measures were taken, including specialist cleaning followed by testing of areas within the unit to ensure they were free of MRSA, and screening of patients and staff in the maternity unit in Letterkenny to prevent further cases. However, the mother of one of the infected babies, who also has three other children, wondered whether the control measures had been put in place as a result of the cases and whether they could have been introduced sooner. That is the main reason I have raised this matter.

We all know that MRSA is a difficult name to pronounce: methicillin-resistant Staphylococcus aureus. I prefer to call it the superbug. The bacterium is responsible for difficult-to-treat infections in humans and is especially troublesome in hospital-associated infections. It is resistant to some antibiotics but not all drugs. The greatest risk is to patients with open wounds or weakened immune systems or who have been fitted with invasive devices. Improper sanitary procedures may transfer bacteria from patient to patient. These are facts with which most people are familiar at this point. I am interested in prevention strategies, which include patient screening upon hospital admission; surface sanitisation and the use of appropriate disinfectants; the use of personal protective clothing such as gloves, surgical masks and eye protection; the isolation of MRSA-positive patients; hand washing and alcohol-based hand rubs, and the availability of adequate facilities and supplies that encourage workers to practice good hygiene. These are aspects of what we are familiar with in terms of the hospital location.

However, the difficulty with MRSA is that is it not confined to hospitals but is found in every community. In this instance I wish to draw attention to its presence in dentists' surgeries, outpatient settings and health care facilities — anywhere a high degree of hygiene is necessary. That is why I am raising this. Some people are concerned about whether aerosols and spatter generated during dental treatment can spread MRSA, and whether dentists are provided with the same resources as hospitals to allow them to institute infection control procedures. Some issues of simple hygiene are mentioned quite often in the Seanad; for example, do dentists wear their uniforms outside the dentist's office? What about other people working within the system?

The Dental Council of Ireland has a code of practice for infection control in dentistry, which states: "If recommended infection control procedures are followed and accidental inoculation by sharps is avoided, there is minimum risk of transmission of serious infectious diseases during dental treatment". Are we pursuing guidelines similar to those which operate in the USA under the American Dental Association? In 2003, these guidelines included educating and protecting dental health care personnel; preventing transmission of blood-borne pathogens; hand hygiene; personal protective equipment; attention to contact dermatitis and latex hypersensitivity; sterilisation and disinfection of patient care items; environmental infection control; attention to dental unit water lines, biofilms and water quality; and other special considerations, such as the use of dental hand-pieces and other devices, radiology, parenteral medications, oral surgical procedures, and dental laboratories.

We currently have audits for hygiene in hospitals. These are keeping our hospitals under pressure to ensure the best standards. We do have an issue with MRSA and other superbugs. If we know how to minimise the potential for the spread of this disease, has the HSE started or does it intends to open up audit facilities for dentists? I know it intends to introduce them for nursing homes and so on. This is not in any way an attack on any individual dentist. I am talking about the implementation of standard procedures and hygiene quality assurance so people can have the confidence in other health professionals that they should have in their local hospitals.

Returning to the original point I made, I trust that those who have contracted MRSA in recent times in any of our hospitals will be given personal follow-up in their cases to try to get them over it. I also trust that we will minimise the number of people in the future who might contract such a dangerous and invasive super bug.