Beaumont Hospital in Dublin is unable to isolate one in three patients with the MRSA "super bug" because of insufficient bed capacity, it has emerged.
The 2006 annual report of its infection control team says that due to overcrowding, staff shortages and poor compliance with hand hygiene, outbreaks of otherwise preventable infections have occurred.
The report, which has been seen by The Irish Times, says internal reviews undertaken on three occasions last year showed that, because of a lack of beds, it was not possible to isolate or ring-fence one in three patients colonised by or infected with MRSA.
"This data confirms the inadequate facilities in the hospital for the control and prevention of MRSA as well as for other infections," the authors say.
With the first National Hygiene Service Quality Review to be published today by the Health Information and Quality Authority (Hiqa), there will be concern that a leading Dublin teaching hospital and the national centre for neurosurgery and kidney transplantation is unable to achieve adequate infection control because of a lack of resources.
The hygiene review is expected to show that a majority of acute hospitals in the State need to improve standards of cleanliness and patient safety.
Outlining the need for a new intensive care unit and a new renal dialysis unit at Beaumont, the report states: "The physical resources of the hospital are under enormous pressure to deliver a quality service and serious questions remain about the safety of patients in certain situations, for example non-MRSA patients being cared for in ward areas with MRSA positive patients due to inadequate isolation facilities and a cramped, outdated intensive care unit."
However, hand hygiene practices by staff at the hospital have improved, with the latest figures showing a 66 per cent compliance rate, compared with 42 per cent in a 2005 audit.
While the number of patients testing positive for MRSA and for another healthcare acquired infection, vancomycin resistant enteritis (VRE), rose in 2006, the report says there has been a further decline in the incidence of Clostridium difficile infection in Beaumont. However, one of 150 cases of the bacterial infection was the highly virulent C Diff 027.
Some 528 new cases of MRSA were identified among inpatients at the Dublin hospital during 2006.
An additional 119 cases of the super bug were found in the outpatient and emergency departments.
Commenting on the latest report, Prof Hilary Humphries, consultant microbiologist at Beaumont and professor of clinical microbiology at RCSI, said "this really reflects the mix of patients we are looking after in a hospital infrastructure designed 30 years ago.
"The structure of the hospital needs to change to reflect an increasing complexity in patient care and the vulnerability of patients to infection."
See Health Supplement