Topical themes


University of Twente has launched a website designed to reduce the incidence of the notorious ‘hospital bacteria’ MRSA. Both patients and staff can find much practical information at The concept can be readily adapted to help tackle other infectious diseases.

A hospital exists to cure patients. However, the very nature of a hospital, in which there could be all sorts of bacteria, fungal spores, viruses and parasites, places patients at greater risk of developing a further, entirely unrelated, condition during their stay.

For many years, the proportion of patients who contract a bacterial infection in a Dutch hospital has remained stable at approximately three per cent, largely due to effective hygiene measures. In Germany, the percentage is far higher, having risen from 2% to a staggering 25% in recent years. Because there is considerable movement of staff and patients between hospitals close to the border between the two countries, Dutch hospitals in the eastern region are particularly susceptible to infection.

The best known 'hospital bacteria' is MRSA. A healthy person is unlikely to suffer any adverse effects from MRSA but those with a compromised immune system can become seriously ill, with symptoms ranging from open sores to pneumonia and blood infections. In the worst case scenario, an MRSA infection can be fatal.

To address the transnational problems in healthcare, various 'Euregional' projects have been launched. One such project is the Twente-Münsterland MRSA net, in which the University of Twente has developed a website intended to prevent the spread of infectious diseases across the national borders. The website, which is in both Dutch and German, was developed in association with the Twente Achterhoek Microbiology Laboratory and a number of German research institutes.

Information and instructions
The MRSA-net website provides both information for patients and instructions for hospital staff. Patients and their families can find the answers to practical questions such as 'are there drugs to cure MRSA?' and 'what special precautions must I take if I have MRSA?'

However, it is the instructions for staff that will do most to reduce the incidence of MRSA. In the past, doctors and nurses have been expected to follow a strict protocol setting out what they must do to minimize the likelihood of coming into contact with the bacteria. The problem was that this protocol runs into hundreds of pages. It takes valuable time to read it all, and staff were not always able to find the information they needed at that precise moment. Using the website, on which questions and answers are arranged in convenient sections, they can quickly discover what they must do in any given situation. Being online, the instructions are available at any time and can be accessed from any computer in the hospital.

The website concept can be used to reduce the spread of many infections other than MRSA. Clear online instructions can also help staff tackle those caused by fungal spores, parasites and viruses. Fenne Verhoeven, the University of Twente Researcher who developed the MRSA-net website, now plans to set up similar sites addressing dangerous viruses such as hepatitis C, HIV and influenza.

A resistant bacteria
MRSA is a strain of Staphylococcus aureus, which is insensitive to the antibiotic methicilline. MRSA actually stands for 'Methicilline Resistant Staphylococcus aureus'. MRSA is also commonly referred to as 'the hospital bacteria', because it is particularly prevalent in hospitals due to the widespread use of antibiotics. This can be explained by genetics. Bacteria reproduce extremely quickly. In each new generation there will be some bacteria with slightly different genes to those of the previous generation. If one of the 'mutant' genes has the effect of protecting the bacteria against a certain type of antibiotic, the resistant bacteria will survive while all the non-resistant bacteria will be killed off. The resistant bacteria can then multiply, with each successive generation carrying the gene which makes it resistant to antibiotics.