Ben Goldacre
Saturday November 19, 2005
The Guardian
I realise this is starting to look like some kind of dirty protest, but here is a window on to how the media sees itself in relation to scientific expertise, and how it copes with criticism, which just happens – entirely by coincidence – to involve the MRSA scandal.
To recap: bloke with no microbiology qualifications in unaccredited garden shed “laboratory” finds MRSA on swabs given to him by undercover tabloid journalists for their “dirty hospital scandal” stories, but proper labs cannot find MRSA in the same places that this “leading MRSA expert Dr Chris Malyszewicz” (with his unaccredited American correspondence course PhD) has, and proper microbiologists have very good reasons for believing that the methods of this “expert” (who incidentally sells a range of anti-MRSA products) could not distinguish between harmless skin bacteria and MRSA.
Article continues
After the Evening Standard published an article starring Malyszewicz, “Killer bugs widespread in horrifying hospital study”, in which it claimed to have found MRSA in some very unlikely places in UCL hospital, two senior consultant microbiologists from UCL, Dr Geoff Ridgway and Dr Peter Wilson, wrote to the paper pointing out the problems with its methods. Not only did the Evening Standard not bother to reply, it ran another story, two months later, using the same flawed methods.
That time Dr Vanya Gant, another UCL consultant microbiologist, wrote to the paper. And the Standard did deign to reply: “We stand by the accuracy and integrity of our articles. The research was carried out by a competent person using current testing media. Chris Malyszewicz … is a fully trained microbiologist with eighteen years’ experience … We believe the test media used … were sufficient to detect the presence of pathogenic type MRSA.” What you are being told here is that tabloid journalists know more about microbiology than microbiologists.
Newspapers often like to believe that they have blown the lid on a huge scandal in which the entire medical establishment has joined hands to suppress the awful truth. This was the structure of the MMR story and the MRSA swab story, and many others. If it’s true, then the evil architects of medical lies haven’t sent me the circular. In fact, send me one example of a story where there was a unanimous medical conspiracy, and I will send you by return of email one video of me eating a copy of this article.
Now I only mention this because on Monday, Radio 4 did a slot on Chris Malyszewicz, chasing up this story (hear it here). The really interesting bit comes at the end. The Evening Standard gives a statement saying: “We were not aware of any official advice that undermined our investigations.” My question to them, in the form of a thought experiment, straight from Karl Popper, is this: what piece of information could we imagine, even hypothetically, that would be sufficient to shake your belief in your MRSA results?
· Please send your bad science to bad.science@guardian.co.uk
tom said,
November 19, 2005 at 1:42 pm
Hm, maby an undrcover investigation into the “resuch labortry” where the tests were carred out, shown on prime time TV, and spun in such a way as to totaly discredit that labs results, and the humanitie graduate science corisponats of the tabloid press? Might do it, or maby it needs to be in a film, somthing like Super Size Me for science.
I would have said a public apolagy by the MRSA “expert” owner of chemsol, but I doupt it would make much diferance.
Or prhaps the moment they can make an exclusive hedline along the lines of: “Garden Shed science – results faked.”?
Sam said,
November 19, 2005 at 1:58 pm
You and Yours Radio 4
Monday 14th November 2005 1205
For the past couple of years a number of scare stories about high levels of MRSA have appeared in many of our tabloid newspapers. And behind the papers’ shock headlines is the man the popular press has dubbed “Britain’s leading expert on MRSAâ€, Doctor Chris Malyszewicz, whose company Chemsol Consultancy in Northamptonshire boasts that it’s among the leaders in helping fight MRSA, and which, via the tabloids, has helped to expose the shortcomings of a series of prominent hospitals.
Quote: We test eight hospitals in Britain for killer MRSA and find it rampant in every one. With the help of expert Doctor Chris Malyszewicz …
Quote: Our samples were examined at the Chemsol Lab in Northampton by Doctor Chris Malyszewicz. He said ….
Quote: Microbiologist Chris Malyszewicz who carried out the tests said “Cleanliness in many hospitals …â€
Quote: Leading MRSA expert Doctor Chris Malyszewicz added “We have to make sure that …â€
Quote: Microbiologist, Chris Malyszewicz, said he was shocked …
Quote: MRSA expert Doctor Chris Malyszewicz said “We need to return to the days of the early 1990’s where washing was done in hospital laundries.â€
JW: Well according to tests carried out by so called Doctor Malyszewicz he’s found MRSA at hospitals up and down the country. But is Chris Malyszewicz really the expert that he and the tabloids would have us believe because many of the hospitals where he found evidence of MRSA subsequently carried out their own tests which gave negative results? Indeed the Malyszewicz testing methods became such a cause for concern that in July last year the Government’s Inspector of Microbiology and the Health Protection Agency visited his back garden laboratory to see for themselves his procedures for sampling, transporting and testing for MRSA. And later this month Baroness Pitkeathley will be raising the concerns of health care professionals in Parliament.
Well someone who’s been following the story week by week recently is the hospital doctor Ben Goldacre, who writes the Bad Science column in The Guardian.
Doctor Ben Goldacre (Bad Science Columnist, The Guardian): Well I first got interested in it when a, about a year and a half ago friend of mine who’s an investigative journalist, an undercover journalist on another paper rang up and he said, “I’ve been taking all of my swabs for my undercover MRSA swab scandal from a local hospital and they’re all coming back negative.†And he said, “What am I doing wrong?†And I sort of said “Well, you know, you’re, what you’re probably doing wrong is imagining that they should be positiveâ€, ‘cause it’s unlikely that you’d grow MRSA from the kind of places that he was taking them from, sort of door handles and, and that sort of thing. And he said you know he’d tried several different labs and, and he was worried that he wasn’t following the protocol properly. And I said well you know probably best to leave it, which wasn’t the answer that he wanted obviously.
He came back to me about ten minutes later very triumphantly and he said, “Oh I’ve, I’ve just rung up…†well I shan’t mention her name, on a different tabloid, and he said, “She’s told me the lab to go toâ€, and he described that lab as “the lab that always gives you positive results”, which obviously sounded very dubious to me.
Now as soon as I realised that, I started looking through the archives and I saw that it was true. In fact all of the positive MRSA swab scandals in every single newspaper all came from one company called Chemsol, based in Northants, with a chap called Doctor Malyszewicz. And that’s when I started looking in to the story. It turned out that Dr Malyszewicz wasn’t actually a doctor. He’s got a non-accredited mail order correspondence course PhD from America and a, I think a, a, a, a polytechnic degree in chemistry from a very long time ago.
JW: So he’s not a microbiologist?
BG: No, absolutely not. And I think when you’ve got somebody who’s not a microbiologist who’s giving positive results where other people aren’t and who is the place where all the tabloids are going, so all the tabloid, there’s not a single tabloid story that hasn’t come out of this one lab, and I, and I, I would say that the (indistinct), the reason for that is that if they went anywhere else they wouldn’t get the positive results that they want for their story. In fact people have gone round behind them in hospitals, on the very day I think that they’ve done their tests, if not the day after, where nothing’s been changed in the hospital, and they’ve got negative results.
JW: So what does this say about the reporting of MRSA by the popular press?
BG: Well I think they, I mean they just wanted a, they wanted a, an MRSA swab scandal and they knew the man that was going to give it to them. I think it, I mean it’s pretty wily really. And the, I think it’s also a shame because MRSA is obviously a, a problem and I think it undermines, you know it undermines the, the, the reality of the problem with MRSA. And it also undermines the integrity of the press when they’re going round very clearly seeking out laboratories that will give them specific, you know the, the results that they want.
JW: But, but MRSA, as you say, is a big problem, I mean it results in many needless deaths every year, I mean surely any highlighting of the issue is justified?
BG: I just don’t think it’s right for journalists to go round making up stories like that.
JW: Well they’re not making it up of course. They’re, they’re being supplied these, these figures by Mr Malyszewicz. You’re just saying that you question the figures; you have questioned his results.
BG: Well that’s very interesting. I mean when you talk to Mr Malyszewicz it’s very obvious from the moment you get to him that this is not a man who knows his stuff. I mean, he talks in a very confused and confusing and slightly incoherent way. He uses technical terminology incorrectly. He mispronounces the names of very common bacteria. And also I understand from readings of reports of people who’ve been to his premises that really it’s just a shed in the back garden. It doesn’t have proper laboratory fittings. It’s got basically kitchen fittings.
I think the problem really is that the tabloids they all desperately want to be sort of Julia Roberts. They want to sort of be the sort of you know the dramatic campaigning journalists who’ve found …
JW: The Erin Brockovich?
BG: Yeah absolutely. They want, they want the big scandal and they’re willing to, to do anything to put themselves in that quite grandiose position but I, but it’s just not the reality with this story.
JW: Well joining us now is the Government’s Inspector of Microbiology, Professor Brian Duerden. He’s in our Cardiff studio.
And Professor Duerden when you visited Mr Malyszewicz’s laboratory back in July 2004 what did you make of it? What did you make of his, his testing procedures?
Professor Brian Duerden (Inspector of Microbiology): Well there, there were two things. The laboratory itself is a, a small building as has been described by, by Ben Goldacre. And (indistinct) …
JW: It’s a garden shed. It’s a garden shed.
BD: It’s, it’s better than my garden shed but it is a wooden building in his garden and it’s not equipped to the level I would expect of a laboratory. It certainly would not pass any accreditation standards, whether this was with Clinical Pathology Accreditation or with the UK Accreditation Service.
JW: And what about his methods for testing MRSA? Were they of a sufficient standard to give accurate results?
BD: I was not at all convinced by his methods. In particular he was not doing methods that (indistinct) distinguished between common, harmless Staphylococci from the skin, Staphylococcus Epidermidis, which is very often Methicillin Resistant, but is, is not a harmful pathogen. Doesn’t distinguish between that and Staphylococcus Aureus which then can be Methicillin Resistant and is the problem organism.
JW: So you wanted to check? I mean he got these results that nobody seemed to be able to replicate, that there was MRSA present in various places. You wanted to check those. He sent you ten of his isolates, as they’re called, in which his tests showed his evidence for MRSA. What did you find when you looked at his findings?
BD: Well when I visited nearly eighteen months ago with, with a colleague we asked him to send some of his isolates to the Centre for Infection, which is the Health Protection Agency Laboratory at Colindale, the national reference facility for Staphylococci, Staphylococcus Aureus. Now he didn’t send them to my laboratory because that would be inappropriate; he sent them to the Health Protection Agency eventually a few months ago. And of the ten isolates that were sent in I believe two were identified as Methicillin Resistant Staphylococcus Aureus, MRSA, but they were of, of a very unusual type.
JW: So where do you think they may have come from there? Where did they turn up?
BD: I, I’ve, I’ve no idea. He’d, he’d been sampling in an environmental setting somewhere in, in an NHS premises.
JW: So let’s be clear, of those ten samples that he sent you eight were just wrong and two were extremely dubious. Is that what you’re saying?
BD: Eight did not contain MRSA. Two did contain an MRSA but it was a very unusual strain. It was not one we would expect to find, or have found, in, in, in patients in this country.
JW: So what (indistinct), what effect has Mr Malyszewicz’s results, what’s that had on patients and staff at the hospitals where he’s conducted these tests and, and which have appeared in the, in the headlines as a result?
BD: Well there are two things. One, it frightens patients and it puts them off getting treatment in the NHS. The other is that it diverts the resources in those hospitals to answering unfounded criticisms. And this isn’t to say that MRSA’s not a problem; we do have hospital infections, health care associated infections, with this organism. But this, when you have wrong reports coming out, this just actually does nobody any good you know because science has to be based on fact, medical science has to be based on fact.
JW: But as the Government’s Inspector of Microbiology do you not have any powers to prevent someone like apparently Mr Malyszewicz who, about whom you have concerns, from, from carrying out such tests in his laboratory and publishing the results in the tabloids?
BD: Well in fact not, not really because I, I have no right to go in and, and shut (indistinct) his laboratory down. It’s his private business. He is, he’s not a member of a professional body; he himself is not a, a registered health care scientist or like myself a medical doctor who is, is a Fellow of the Royal College of Pathologists. So there isn’t a professional body or a, a body like the Medical General Council; so there’s none of that. Neither his, his laboratory accredited so I, I can’t go to an accrediting body to suggest that that be withdrawn. So there, there isn’t a sanction there because he’s not within the, the formal system.
JW: And what’s been the response of the popular press when you’ve raised your concerns about Mr Malyszewicz’s testing procedures with them?
BD: I’ve, well as you will have seen from the, the reports that have come out they, they have carried on and, and published this work and used his evidence.
JW: Well listening to all of this is Chris Malyszewicz of Chemsol Consultancy. He’s in our Northampton studio.
Mr Malyszewicz your results according to Professor Duerden there are, are not valid. What do you say?
Chris Malyszewicz (Chemsol Consultancy): (Indistinct) I tend to disagree actually. I’m not, not saying point blank that the fact at the end of the day we have got MRSA all over the place ‘cause we haven’t. And in fact if you, if you look carefully, which a lot of people haven’t, that the MRSA reporting that we’ve done in the last three years, or three and a half years, has actually been forty five per cent have been negatives anyway. Those obviously are never reported and never be factual because those results are still on our system and have never been actually disclosed. So in fact when somebody says, well yes it’s the lab that always produces MRSA positive results the answer’s no it doesn’t unfortunately …
JW: But do you feel comfortable with the way you’ve been referred to in, in the popular press you know as an MRSA expert?
CM: For the last thirty two years my job has, my living has always been involved in disinfection studies and bacteriological detection. Part of that work has been with new contact slides which have been to identify specifically Staph Aureus and Methicillin Resistant Staph Aureus (indistinct) …
JW: But you, but, but I mean you’re not a doctor are you? You’re not a microbiologist. Your, your lab is in a large, what amounts to garden shed. It’s not accredited and its results according to the Government’s Inspector of Microbiology are dubious to say the least and wrong in most cases.
CM: I think I disagree with that very strongly. Based on the issues that we actually are not a Government funded laboratory; it is out of my own pocket; it’s something that I’ve had to pay for dearly myself. The MRSA issue is something that I was bludgeoned or pushed in to. It’s not a particular area that I’m, I’m particularly au fait with or an area which I’m not really very comfortable with. It’s …
JW: So you’re, you’re admitting you’re not qualified to carry out these tests that the tabloids then trumpet as, as being valid?
CM: I’m sorry that I am qualified to take the tests. We’ve also …
JW: You said you were not au fait with this area. It’s rather important that you are isn’t it?
CM: Well when I say au fait in other words it’s not something that I have studied in depth until four years ago, that when we took this up as a long term project it was something that we actually embodied in to the actual contact slide principles. Now we have taken a lot of information from the right people, from Oxoid and those companies which are very experienced in detection of MRSA. The PB, or Penicillin Binding test is the ultimate gold standard for detecting Methicillin Resistant Staph Aureus on the (indistinct). I’m not saying for a minute I don’t think they’re wrong. If they are wrong then obviously we’re back to the drawing board.
JW: But if your results are wrong, I mean you’ve slurred the reputation of hospitals; you’ve unnecessarily alarmed patients and of course you’ve cost the tax payer a great deal of money as these tests are done all over again by the hospitals who then report they find nothing.
CM: I’m, I’m very sorry to say that but in fact there’s a Scottish laboratory twelve months ago who did an independent result themselves and their results were horrendously higher than I’ve ever found before. So, no, I think that’s completely wrong to say that.
JW: But Mr Malyszewicz I mean you, you sell don’t you a range of anti bacterial products, so called MRSA kits. I mean you have a vested interest don’t you in finding MRSA because you, you sell the, you sell the stuff to get rid of it?
CM: Interesting question………… In fact… no, I’m not. As a formulator of a disinfection for industry and personal hygiene this, this is my living. I am unfortunate not to have vested interest in MRSA as this was never designed to enhance any sales of products. If I wanted to I could have offered products over three years ago when the situation was first discovered. It didn’t happen that way.
JW: How much money do you charge for one of your undercover investigations?
CM: Well per contact slide, and if it’s to do with the Penicillin Binding test, the (indistinct) test plus that we do for, and the Baird Parker and secondary cultures we, we, about thirty five pound to forty seven (indistinct) …
JW: So it’s quite lucrative since as I understand it some twenty articles have appeared where you’ve undertaken extensive research?
CM: I wish it was lucrative….. Our accounts don’t show that unfortunately.
JW: So are you not surprised when subsequently hospitals undertake their own tests and they find no traces of MRSA? How can they all be wrong, indeed the Government’s own Inspector of Microbiology be wrong, and, and you be the only one right?
CM: Well no I’m not. Why should they as it’s not in their interest to show negative results and high level of infected materials.
JW: Professor Duerden you’re, you’re, you’re listening to this. What’s your response to what you hear?
Professor Brian Duerden: If you’re to identify an organism Staphylococcus Aureus it’s not enough just to grow it on an initial detection slide. You then have to go through a series of tests to identify it. The slides themselves are not sufficiently selective to just grow MRSA and I think that is where part of the problem is.
JW: And what about the point made by Chris Malyszewicz that of course hospitals, it’s in their interests not to find MRSA. No wonder they say they don’t; they don’t want to.
BD: Well I, I would, I would challenge that (indistinct), very much. We’re talking here about people who are not only qualified but dedicated scientists who have a job to do. It’s not a case of ‘in our interests’. If, if there is contamination there then it would be found.
JW: So what, I mean what would you like to happen to Mr Malyszewicz and his research? Would you like it to stop or him go back to the drawing board or what?
BD: I think if, if this sort of work is to continue it must be done to the sort of quality standards that we would expect of any laboratory serving the NHS.
JW: I mean if I can just pick up again with you Chris Malyszewicz, what, what about the results of the tests that the Health Protection Agency carried out on the, on those isolates that you sent them, where you’d found evidence of MRSA? I mean they found MRSA on only two out of those ten examples and the MRSA on those two was a very rare Australian strain, unlike anything that’s ever been found in the United Kingdom. Do you by any chance work for any Australian companies? Could there be cross contamination?
Chris Malyszewicz: I don’t work for an Australian company, no. We’ve only done one ever run for Sydney, which was prior to that anyway and those isolates were (indistinct) prior to any other work being sent to Colindale.
JW: But if your results are wrong, as so many experts say they are, don’t you accept you have caused the tax payer an awful lot of unnecessary expense and you’ve caused a great many people a great deal of worry and concern?
CM: No. I, that’s another thing I disagree. I have offered to do contact slide work in conjunction with any microbiologist and that was over a year and a half ago in any hospital that (indistinct) nominated that we know MRSA is a problem. And in fact I, I would guarantee that there would be positive results after a, a hundred slide survey.
JW: Chris Malyszewicz of Chemsol Consultancy, Professor Brian Duerden, the Government’s Inspector of Microbiology, and doctor and Guardian columnist, Ben Goldacre.
Well we asked some of the tabloids who’ve used Mr Malyszewicz over the past couple of years to carry out their undercover investigations why they did and whether they would continue.
The Sunday Mirror declined to comment but The Sun said, “We stand by all our MRSA investigations done by Mr Malyszewicz. If our headlines have embarrassed the Department of Health in to taking action against MRSA then we are very pleasedâ€.
And the London Evening Standard told us, “Along with other newspapers and broadcasters we have in the past used this company to carry out tests as part of our reports. We were not aware of any official advice that undermined our investigationsâ€.
Well Doctor Goldacre has vowed that he’ll go on writing about this in his weekly newspaper column until the, the tabloids desist from using Mr Malyszewicz. From their response it looks like he’ll be putting pen to paper for quite some time.
Robert Ward said,
November 19, 2005 at 2:13 pm
Tabloid journalists may not know much about microbiology but they know how to write a good story, and “little guy in garden shed proves the establishment wrong” is a great story – just like you see in the movies. If you’ve got on ‘ology’ and a piece of paper that says Ph.D, that makes you two up on most tabloid journalists who probably couldn’t even tell you what MRSA stood for without looking it up.
That they don’t know what they’re talking about is when they use phrases like “pathogenic type MRSA”. Excuse me? Staphylococcus aureus is a common enough bug – which is the point they can’t seem to grasp – and mostly pretty harmless (all things considered) until it gets in the wrong place. They can’t even grasp the real issue that it’s not about allegedly “dirty hospitals” (though that’s not to say high hygiene standards aren’t needed!) but the fact that the bugs are winning by evolving resistance to our armoury of medicines. Maybe we should just sue the intelligent
designer?
Nicholas Avenell said,
November 19, 2005 at 2:28 pm
They could conduct an undercover investigation of the MRSA Shedbratory by disguising themselves as rats.
Pondering how difficult this exercise would be is left as an exercise for the reader.
Miss Prism said,
November 19, 2005 at 2:34 pm
I hope Dr Malyszewicz follows appropriate garden pathology procedures, such as disposing of his MRSA samples in a bonfire rather than on the compost heap.
amoebic vodka said,
November 19, 2005 at 3:07 pm
If you listen to the radio 4 interview, he mentions autoclaving the Australian samples:
“Chris Malyszewicz: I don’t work for an Australian company, no. We’ve only done one ever run for Sydney, which was prior to that anyway and those isolates were (indistinct) [autoclaved] prior to any other work being sent to Colindale.”
Operating an autoclave without proper training? He’s braver than we are. That or he has a very fireproof shed. Also, just because he disposed of the waste, it obviously doesn’t rule out cross contamination. It only takes one bacterium to grow into a colony on a plate after all.
Natalie said,
November 19, 2005 at 5:03 pm
Surely one newspaper will crack soon and run a huge piece on how the “leading MRSA expert” is actually a bit (or a huge) laughing stock. I won’t hold my breath, it would force them to acknowledge they were wrong in the first place and the newspapers (especially the tabloids) hate to admit that!
Bit off the point but I have just finished reading a paper for my third-year project with some very bad science in it, the manipulation of statistics to produce significant results.
JonnyW said,
November 19, 2005 at 6:04 pm
I hope I understood Mr M correct in the radio interview but when asked about cross comtamination he did say as ameboic vodka has pointed out
“I don’t work for an Australian company, no. We’ve only done one ever run for Sydney, which was prior to that anyway and those isolates were (indistinct) [autoclaved] prior to any other work being sent to Colindale.â€
Well if it is him posting this in an MSRA forum may be cross contamination came from here see posting of “Chris” on 25/26 May 2005 page 4
www.robprince.net/mrsa/forum.asp?action=replies&page=4&forumID=3054
“I was at ITN at the time being interviewed. It came a shock to me.
At present I am culturing Strains from California USA and Melbourne, Australia and expecting certain shocks as these again are community strains.”
Not sure about the time line of the tested mind as Professor Duerden only says of the 10 samples “he sent them to the Health Protection Agency eventually a few months ago”
Rosie said,
November 20, 2005 at 7:30 pm
Wow, that thread is full of real stupid, JonnyW.
I especially liked this post:
“Ironically it isn’t an eczema cream, but instead is a hand protector from a high street retailer which contains cannabis. If I had the same attitude as those who are criticising Brian and Chris over the ingredients of their cream, I would be having a total fit over the fact that I am using something on a 3 year old which contains cannabis, and questioning the ethics of the Body Shop in selling such a product.”
Um……….
Rosie said,
November 20, 2005 at 7:33 pm
Sorry to double-post, but here is a fab quote from “Chris” (who says he is Chris Malyszewicz, but of course it might not be him)
“Sadly I had 2 government official advisors from John Reid who
came to inspect my privately owned laboratory and to check my new methods of MRSA determination.
They went away with nothing apart from the surprise at what expense and effort I had gone to with correct equipment for the job!”
I’m guessing that would be surprise at how little expense and effort he had gone to?
Nasty Jim said,
November 20, 2005 at 7:51 pm
That whole forum is excruciating to read: the whole anti-MRSA scene appears to be a minefield of dubious credentials. Check out the Products Forum too: latest silliness is someone professing to represent a group called Academia, which will “decided to monitor the press and internet for misinformation regarding products marketed to the healthcare sector. The reason for this is because we need to uphold standards of ethics and efficacy and correct, or expose, individuals and companies that publish information that is misleading or untrue“. Except they won’t tell you who they are, so any statement isn’t worth a damn. They do include two “microbioligists” though.
Sam said,
November 21, 2005 at 12:09 am
Perhaps somebody working at Chemsol Shedquarters has this rare Australian MRSA living in their nostrils?
MikeTheGoat said,
November 21, 2005 at 8:38 am
My favourite bit of press reporting about MRSA is a discussion about finding “the methicillin sensitive strain of MRSA”. So that’s just plain staph then? How worrying.
Delster said,
November 21, 2005 at 12:03 pm
maybe UCL should pose as a reporter and send Chemsol a swap from the inside of an autoclave just after it finishes it’s cycle and see what he manages to conjure from that 🙂
Pete said,
November 21, 2005 at 12:37 pm
I don’t want to defend what sounds like poor confirmatory procedures and obviously using fake titles is bad. However I’d like to add that a having a PhD and an accedited lab are not essentials for detecting MRSA – it’s about the level of an undergraduate experiment.
Malyszewicz’s results can’t be relied upon, but neither can we confidently expect that hospitals are taking this in hand. They do not allow people to come in and sample the environment, and do not routinely (if ever) do so themselves. Guidelines say wards are to be visually clean, nothing more.
If hospitals did so, and were open about the results, media scare stories (and people making money off the back of them) wouldn’t be a problem.
Edie said,
November 23, 2005 at 11:05 pm
The dirty hospitals and MRSA link is just Bad Science.
Hospitals actually do spend a great deal of time and resource isolating and typing Staph. aureus from patient samples. They don’t spend much time looking for it (methicillin sensitive or resistant) on hard surfaces as it just doesn’t survive there. S. aureus, although it may be antibiotic resistant, is very susceptible to cleaning materials and the stress of not being above 30 deg C. It’s a skin/nose/mucous membrane micro-organism. I’m not saying it isn’t a problem in our hospitals – of course it is: our hospitals are full of people – but it’s not associated with dust on the floor.
Now if you want to look for trouble – a pathogen with the ability to survive on hard surfaces and a risk to the immunocompromised – look for a Gram negative environmental microorganism like Acinetobacter sp.
Tom said,
November 24, 2005 at 2:56 pm
Questions should be asked. And they will be – this is scheduled for the House of Lords on 30th November:
*The Baroness Pitkeathley—To ask Her Majesty’s Government what is their response to reports that tests for methicillin resistant staphylococcus aureus (MRSA) may be falsely positive as a result of using a single laboratory.
Lord Warner (DoH) is due to reply.
bcpmoon said,
November 24, 2005 at 3:19 pm
What about a little experiment? If I read this right, then Mr. Malyszewicz (copied that) should get false positives nearly all the time. Why not do a swab test with samples from all the tabloids offices? (Of course blinded) The expenses would be worth it, I think.
amoebic vodka said,
November 24, 2005 at 7:08 pm
A swab test from Chris Malyszewicz’s nose/skin tested in an accredited lab might be more amusing.
Pete said,
November 28, 2005 at 3:12 pm
Edie, do you have any evidence that MRSA and hospital surfaces is Bad Science?
Because from where I am typing, you are using the bad practice of one person to smear an entire branch of investigation. The work on dust and floors is decades old, and specific to dust and floors. Your claims about MRSA on surface don’t bear much scrunity either.
Wagenwoort (JHI, 45, pg 231-234) found MRSA strains survived longer than 6 months on surfaces. Outbreak strains survive even better. They have high salt and dessication tolerance which helps too. As you will be aware, disinfectants aren’t used to clean wards, detergents are. Detergent don’t have anti-bacterial properties (except QACs which aren’t used either)
Too many papers for me to type have recovered MRSA from surfaces, including
Floor, Bed linen, Patient gown, overhead table, Blood pressure cuff, side rail,
bathroom doorhandle, infusion pump handle, room doorhandle, nurse gowns, nurse gloves, Furniture, Floor, Medical equip, Bed and frame, Flat surfaces, Door handle, Ventilation grill, Radiator Nurse call button, strecher, wheelchair, shower chair, bathtub, footwash, bowl, shower handle, shower curtain, Examination tables, Nurse keyboard, Telephone reciever, Tap, Working table and many other. All in published literature, none with Dr M. Not exhaustive either, I got bored copy and pasting.
So please don’t tell me that MRSA isn’t on surfaces and that it can’t survive there. The link to infections isn’t proven and maybe there isn’t one. But it isn’t Bad Science to try and find out., if you do it properly. Dismissing it without investigating it is.
Ben Goldacre said,
December 1, 2005 at 10:52 am
LORDS MRSA
MINISTER HITS OUT AT `MISLEADING INFORMATION’ ON MRSA
By Anthony Looch, PA Lords Staff
The Government today hit out at “misleading information in the
media” about hospital killer bug MRSA and singled out a company for
criticism.
The claims were levelled at Lords question time by Health Minister
Lord Warner who named Dr Christopher Malyszewicz of Chemsol
Consultancy Ltd.
He said: “The main source of this misleading information in the
media is Chemsol which is run by a person who is not qualified in
microbiology.
“He is not a member of a recognised professional body and his
so-called laboratory does not meet UK accreditation standards.
“It is disappointing that test results for MRSA, produced by
unsound methods, are given wide publicity in the media.
“This causes unnecessary public concern and wastes NHS resources
in countering them.”
Lord Warner was replying to Labour’s Baroness Pitkeathley, who had
asked what the Government’s response was to reports that tests for
MRSA “may be falsely positive as a result of using a single
laboratory”.
Lord Warner told her: “Laboratories doing microbiological
investigations should be accredited or registered for accreditation.
“Tests must be undertaken in accordance with approved standards
and operating procedures and results should be validated by process
controls, internal quality control and participation in an external
quality assurance programme.”
Lady Pitkeathley asked: “Would you agree that the continued use by
the tabloid press of one particular laboratory, with questionable
qualifications and results, shows more interest in criticising the
NHS than reporting the facts?
“Are you concerned that this particular laboratory appears to
derive most of its income from selling disinfectants to combat MRSA
and so might perhaps be seen to have a vested interested in achieving
positive results?”
Lord Warner replied: “I entirely agree with you about the
laboratory concerned and the uncritical acceptance of its results by
some parts of the media.
“The main source of this misleading information in the media is
Chemsol which is run by a person who is not qualified in
microbiology. He is not a member of a recognised professional body
and his so-called laboratory does not meet UK accreditation
standards.
“The methods used in this laboratory do not distinguish between
harmless bacteria found on the skin and the potentially harmful
MRSA.”
Tory Baroness O’Cathain asked: “If this laboratory does not reach
accreditation standards, why not close it down?”
Lord Warner replied: “Dr Malyszewicz, who is the owner and
operator of this so-called laboratory – I am using that term
advisedly – is not a member of a recognised professional body as a
microbiologist nor is he a registered health care scientist or a
medical doctor.
“His laboratory is not accredited as a diagnostic laboratory. In
those circumstances, he is not actually claiming to be any of the
things for which we could actually take professional action against
him.”
end
Elmer Phudd, Phrenologist to The Elephant Man said,
December 1, 2005 at 11:24 am
I think that they shouldn’t have just focused on how the lab was not accredited. This will just back fire in the tabloid press as another sign of ‘cover-up’.
They should have drummed the issue home by explicitly referencing the fact that the lab results have never been significantly replicated by independent investigators.
Just my two cents.
Tom said,
December 1, 2005 at 1:01 pm
Here’s the full transcript from Hansard. “You and Yours” gets a mention; Bad Science doesn’t:
2.45 pm
Baroness Pitkeathley My Lords, I beg leave to ask the Question standing in my name on the Order Paper. In doing so, I declare an interest as a survivor of MRSA.
The Question was as follows: To ask Her Majesty’s Government what is their response to reports that tests for methicillin resistant staphylococcus aureus (MRSA) may be falsely positive as a result of using a single laboratory.
The Minister of State, Department of Health (Lord Warner): My Lords, I am sure that the whole House congratulates my noble friend on that.
Laboratories doing microbiological investigations should be accredited or registered for accreditation. Tests must be undertaken in accordance with
30 Nov 2005 : Column 210
approved standards and operating procedures. The results should be validated by process controls, internal quality control and participation in an external quality assurance program. It is disappointing that test results for MRSA produced by unsound methods are given wide publicity in the media. This causes unnecessary public concern and wastes NHS resources in countering them.
Baroness Pitkeathley: My Lords, I thank my noble friend that helpful reply. Does he agree that the continued use of one particular laboratory which has questionable qualifications and results by the tabloid press shows more interest in criticising the NHS than in reporting the facts? Is he further concerned that this particular laboratory appears to derive most of its income from selling disinfectants to combat MRSA and thus might perhaps be seen to have a vested interest in achieving positive results?
Lord Warner: My Lords, I entirely agree with my noble friend’s concerns about the laboratory in question and the uncritical acceptance of its results by parts of the media. The main source of the misleading information in the media is Chemsol, which is run by a person who is not qualified in microbiology, is not a member of a recognised professional body and whose so-called laboratory does not meet UK accreditation standards. The methods used in this laboratory do not distinguish between harmless bacteria found on the skin and the potentially harmful MRSA.
Baroness O’Cathain: My Lords, if the laboratory does not reach accreditation standards, why do the Government not close it down?
Lord Warner: My Lords—
Noble Lords: Oh!
Lord Warner: Wait for it, my Lords; there is quite a good answer.
Dr Malyszewicz, the owner and operator of this so-called laboratory—and I am using the term advisedly—is not a member of a recognised professional body as a microbiologist. Nor is he a registered healthcare scientist or medical doctor. His laboratory is not accredited as a diagnostic laboratory. In those circumstances, he is not actually claiming to be any of the things for which we could take professional action against him.
Baroness Neuberger: My Lords—
Lord Soley: My Lords—
Lord Rooker: My Lords, it is the Liberal Democrats’ turn.
Baroness Neuberger: My Lords, given what the Minister has said, what else could be done to indicate to the public and the media more widely the concerns
30 Nov 2005 : Column 211
that we obviously share around the House about people passing themselves off as experts in microbiology when they are not?
Lord Warner: My Lords, I would certainly commend to the House the work done by the BBC in its program “You and Yours” on Radio 4 on 14 November, which exposed the circumstances involved. We sent down our inspector of microbiology as long ago as July 2004 to inspect these facilities, which were described as a “garden shed” on the Radio 4 programme I mentioned. We have written to the media to explain the circumstances and given them copies of the inspector of microbiology’s report. We expect some parts of the media to behave with a little more responsibility when we have given them this information.
Lord Soley: My Lords, is that not the core of the problem? The MRSA scandal is not the first example of a media scare, with people being genuinely worried and scared by a story that had virtually no substance to it. There have been many other examples of science being misreported in this way. It is not for this House or even the Minister but perhaps for the scientific bodies and, inadequate as it is, the Press Complaints Commission to start looking at how hopes are raised unrealistically and fears are raised unreasonably by press stories that show no scientific understanding. That also undermines public confidence in scientific thought and method.
Lord Warner: My Lords, I agree entirely with my noble friend’s remarks. We all accept that there are some serious issues around MRSA in this country, as there are throughout the whole of Europe, that have to be tackled; but they have to be tackled responsibly and not irresponsibly as has been the case in this area.
Baroness Tonge: My Lords—
Lord Skelmersdale: My Lords—
Baroness Masham of Ilton: My Lords—
Lord Rooker: My Lords, it is the turn of the Cross Benches.
Baroness Masham of Ilton: My Lords, would it not be a good idea to make MRSA a notifiable condition so that a qualified person would sign the form?
Lord Warner: My Lords, consideration has been given to that although it is not the situation at the moment. However, I would say to the House and the noble Baroness that we are the first government to introduce a mandatory surveillance reporting scheme on all healthcare-associated infections. We publish the results on MRSA as part of that. The scheme is being conducted by the Health Protection Agency.
Lord Skelmersdale: My Lords, I understand that the laboratory which has been so rightly criticised by your
30 Nov 2005 : Column 212
Lordships today is not the only one involved in this report. The Minister talked about “validation”. I assume that he meant validation not of laboratories but of tests. In the days of the Public Health Laboratory Service, difficult tests were almost invariably checked in other labs within the service. What is the position now?
Lord Warner: My Lords, there is an arrangement for accreditation, and I can send noble Lords the full particulars. As I said in my Answer, they are based on quality assurance, quality controls and participation in an external quality assurance scheme. So people are not just self-regulating. They are applying in a similar way to that which the noble Lord mentioned.
Baroness Tonge: My Lords, has the Minister read Florence Nightingale’s Notes on Nursing, which was written in 1860 before bacteria were even discovered? It contains an excellent blueprint for hospital hygiene and good nursing care. I wonder whether he would undertake to send it to all hospital managers for Christmas this year.
Lord Warner: My Lords, I certainly would not want healthcare managers to be diverted from their current tasks in managing the NHS and achieving financial balance. However, I shall undertake to read the book if the noble Baroness will undertake to make a full study of all the measures that the Government have taken to improve hand hygiene and tackle MRSA.
Ben Goldacre said,
December 1, 2005 at 2:10 pm
i am unbelievably gutted that i didnt get a mention by their noble lords.
Elmer Phudd, Phrenologist to The Elephant Man said,
December 1, 2005 at 2:24 pm
Hah! Florence Nightingale did though. I bet she’s well chuffed 🙂
David said,
December 2, 2005 at 1:44 pm
On You and Yours today, Friday 2nd December, Liz Barclay claimed that the MRSA lab scandal had been exposed by that program on 14th November. I thought Ben Goldacre had originally exposed the fiasco on Saturday 15th October 2005 and on several other occasions.
Strange Sleep » Blog Archive » Lack of trust said,
February 14, 2006 at 6:05 pm
[…] Are these the same newspapers that often make wild, implausible, (not to mention factually incorrect) extrapolations based on reports in science journals — or are we talking about some different newspapers that I don’t know about? […]
Bad Science by Ben Goldacre | Plausibility.net said,
August 19, 2009 at 8:54 pm
[…] of the stories are truly astonishing. The MRSA superbug scare, so prevelant in 2004, is shown to have been driven by a unethical collaboration between the media […]
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