MRSA bloodstream infections continue to fall

17 July 2008

The Health Protection Agency has today published its latest quarterly figures on MRSA (meticillin-resistant Staphylococcus aureus) bloodstream infections and C. difficile (Clostridium difficile) infections.

These relate to the January to March 2008 period, the final quarter in the 2007/2008 financial calendar, providing annual figures for both infections.

MRSA

The latest figures on MRSA bloodstream infections show that there were 966 cases reported in England during the January to March quarter of 2008. This represents an 11% decrease on the previous quarter (October to December 2007) when 1,088 reports were received.

There was a 30% decrease in the number of cases reported in financial year 07/08 (4,438) compared to financial year 06/07 (6,383). This is the fourth annual decrease in such bloodstream infection cases and the most marked.

Dr Georgia Duckworth, Head of the Agency’s Healthcare-Associated Infection and Antimicrobial Resistance Department, said:

“The substantial drop we have seen in MRSA bloodstream infections over the past year is impressive and a credit to the hard work of our colleagues in the NHS, strengthening good practice in infection control

“If we are to continue this reduction in healthcare associated infections it is vital that the measures which have won this significant success remain in place and that the public and healthcare workers recognise their importance.”

C. difficile

The latest C. difficile figures show that there were 10,586 cases reported in patients aged 65 years and over between January and March 2008. This represents a 6% increase in reported cases in this age group from the previous quarter, October to December 2007, (9,993 cases) but reflects a 32% reduction on the same quarter last year (15,644 cases).

Historically, annual figures for C.difficile have been collated and presented in calendar year format. However, as the new Public Service Agreement on reducing C.difficile infection is based on financial year figures from 2007/08, future annual figures released by the Agency will be presented by financial year. 

Both are available this year, as part of the transition from calendar to financial year reporting:

• Between January and December 2007 there were 50,392 cases of C.difficile reported in patients aged 65 years and over. This represents a 9% decrease on the previous calendar year when 55,635 cases were reported (between January and December 2006).
• Between April 2007 and March 2008 there were 45,334 cases of C.difficile reported in patients aged 65 years and over.

Dr Duckworth said:

“Although there has been mandatory reporting of C.difficile since 2004, this past year has seen major changes to improve the reporting system. We now have a more robust system that will enable us to measure the levels of this infection better and help Trusts manage and monitor the effectiveness of their interventions to improve infection control.

The Health Protection Agency also published today its third annual report “Surveillance of Healthcare Associated Infections 2008”, examining the current picture of healthcare associated infections in England. The report highlights that last year’s confidence that the downward trend in MRSA bloodstream infections would be sustained was not misplaced, with infections continuing to fall across all regions.

It also reports on the early indications that C.difficile infections are falling but, given the significant changes to improve the mandatory surveillance of the C.difficile reporting system, cautions that more time is required to assess whether these falling numbers herald the same type of downturn seen for MRSA bloodstream infections.

In addition, it demonstrates that there have been significant decreases in rates of surgical site infections (SSIs) in the main orthopaedic categories and that English rates of surgical site infection are comparable to those elsewhere in Europe. There has been growing participation in SSI surveillance since 2003, with 224 hospitals collecting data in 2007on 83,444 surgical procedures across ten categories of surgery. 898 SSIs were identified with rates of SSIs ranging from 0.5 to 0.75 infections per 1,000 post-operative days. Rates were found to be highest in surgery where the likelihood of microbial contamination at the surgical site is high e.g. bowel surgery.

The report highlights work in progress, such as outbreak surveillance and areas warranting further attention, like surveillance of particularly vulnerable groups of patients, for instance those in critical care units.

Professor Peter Borriello, Director of the Agency’s Centre for Infections, said:

“It is worth remembering that not all healthcare-associated infections are preventable. However, this shouldn’t lead to complacency around tackling the infections that are preventable and engaging in the battle to continually drive down rates of healthcare associated infections. These figures show that there can be, and have been, significant reductions.”

Ends

 

 

NOTES TO EDITORS

For media enquires please contact the Health Protection Agency’s Centre for Infections press office on tel: 020 8327 6690/ 6647.

The Health Protection Agency publishes mandatory surveillance data for MRSA bloodstream infections and C. difficile infections in a quarterly format. The next set of quarterly data will be published in October 2008. 

Reports of MRSA bloodstream infections and Clostridium difficile infections for individual Trusts are available at:

http://www.hpa.org.uk/webw/HPAweb&Page&HPAwebAutoListName/Page/1191942126522?p=1191942126522

The Health Protection Agency’s third annual report “Surveillance of Healthcare Associated Infections 2008” is available to download from the Agency’s website.

MRSA bloodstream infections

MRSA bloodstream infection figures – a summary of cases reported under mandatory surveillance in England

 

Quarter	Number of MRSA bacteraemia reports
April 2007 – June 2007	1,304
July 2007 – Sept2007	1,080
Oct 2007 – Dec 2007	1,088
Jan 2008 – March 2008	966

C. difficileinfections

Quarterly counts of C. difficile infections – a summary of cases reported under mandatory surveillance in England

 

 

* Prior to April 2007, C. difficile data were only collected for patients aged 65 years and over.

NB: Data are collected at Trust level and are not published by the Health Protection Agency for individual hospitals within a Trust.

Glycopeptide-resistant enterococcal bloodstream infections

Reporting of clinically significant GRE (glycopeptide-resistant enterococcal) bloodstream infections has been mandatory for NHS acute trusts in England since 2003 and is published annually.

GRE are enterococci (bacteria that are commonly found in the bowels of most humans) that are resistant to glycopeptide antibiotics (vancomycin and teicoplanin). GRE were first detected in the UK in 1986 and have subsequently been found in many other countries.

Surveillance figures for GRE bloodstream infections also published today show continuing low levels of infection. Figures have shown a small increase with 910 cases reported from October 2006 - September 2007, compared to 903 in the previous year.

Historically there have been significant year on year increases in the number of GRE bloodstream infection reports received, with a levelling off over the past year.

GRE infections are still low in the majority of Trusts and many Trusts have not yet had experience of these infections, as these infections target very ill patients with serious underlying conditions.

GRE bloodstream infection reports received under the mandatory scheme in England

 

Year	Number of GRE bloodstream infection reports
October 2003 - September 2004	628
October 2004 - September 2005	757
October 2005 - September 2006	903
October 2006 - September 2007	910

Last reviewed: 27 May 2010