HCAI and Antimicrobial Point Prevalence Survey – England

The HPA coordinated England's participation in ECDC's Fourth National Prevalence Survey on Healthcare Associated Infections & First National Prevalence Survey on Antimicrobial Use and Quality Indicators in England. Hospitals in England participated in data collection between September and November 2011.

 

This report provides a snapshot of the levels of healthcare-associated infections (HCAI) and levels of antimicrobial use (AMU) in hospitals in England in Autumn 2011. This is the first survey to include hospitals from the independent sector.

There have been three previous HCAI PPS surveys and the last survey was carried out in 2006. It is difficult to compare each survey as the data was collected in a different way. However, there was an overall drop in HCAI prevalence from 8.2 per cent in 2006 to 6.4 per cent in 2011.  The prevalence of AMU was 34.7%, no previous national survey has taken place.

The English PPS data collection was undertaken by hospital teams between October and November 2011; 103 organisations surveyed 52,443 eligible patients (50,778 from the NHS and 1,665 (3.2 per cent) from the independent sector. The average age of all patients was 69 years old. A total of 4,372 (out of the 52,443, eight per cent) children under 16 years of age were also surveyed.

Key results from this year’s survey have shown that:

·         The prevalence of HCAI was 6.4%. A total of 3,360 patients were diagnosed with an active HCAI with 135 patients having more than one.

·         When comparing ward specialties, HCAI prevalence was highest in patients in intensive care units (ICUs) at 23.4 per cent followed by surgical wards at eight per cent.

·         The most common types of HCAI were respiratory (including pneumonia and infections of the lower respiratory tract) (22.8 per cent), urinary tract infections (UTI) (17.2 per cent), and surgical site infections (15.7 per cent). Since the last PPS in 2006 there has been a eighteen fold reduction overall in MRSA bloodstream infections - from 1.3 per cent to less than 0.1 per cent in patients; and a five fold reduction in C. difficile infections (from two per cent to 0.4 per cent).

·         The prevalence of antimicrobial use was 34.7%.

·         Most antibiotic use (53 per cent) in hospitals was in patients receiving treatment for infections which commenced in the community. Thirty percent of surgical prophylaxis was prescribed for greater than one day. 

Download full publications

1.     English National Point Prevalence Survey on Healthcare-associated Infections and Antimicrobial Use, 2011 (PDF, 1.9 MB) 

2.     English National Point Prevalence Survey on Healthcare-Associated Infections and Antimicrobial Use, 2011 - Appendices (PDF, 3.3 MB) 

3.     PPS Frequently Asked Questions (PDF, 654 KB)  

England PPS Steering Group

Chair: Prof. Anthony Kessel, Director Public Health Strategy, HPA
DH representative: Ms. Sally Wellsteed
HIS representative: Dr. Adam Fraise/ Dr. Barry Cookson
IPS representative: Ms. Tracey Cooper
BIA representative: Dr. Louise Teare
ARHAI Chair/ Paediatric representative: Prof. Mike Sharland
BSAC/ARHAI representative/ Pharmacist representative: Prof. Jonathan Cooke
HPA - HCAI & AMR PB
RM – Dr. Bharat Patel
RE  – Dr. Mark Reacher
HPA Colindale – Prof. Barry Cookson, Dr. Liz Sheridan
Coordinators: Dr. Susan Hopkins, Ms. Karen Shaw

References

 1. European Centre for Disease Prevention and Control: Annual Epidemiological Report on Communicable Diseases in Europe 2008. Stockholm, European Centre for Disease Prevention and Control, 2008
2. ECDC, Importance of Surveillance; Surveillance is essential to understanding the epidemiology of infectious diseases.  Website site 13 May 2011 www.ecdc.europa.eu
3. National Audit Office, Improving patient care by reducing the risk of hospital acquired infection: A progress report, Report by the comptroller and auditor general HC 876 sessiuon 2003-4, London Stationary Office, 2004.
4. Humphreys H, Newcombe RG, Enstone J, Smyth ET, McIlvenny G, Fitzpatrick F, et al; Hospital Infection Society Steering Group. Four country healthcare associated infection prevalence survey 2006: risk factor analysis. J Hosp Infect. 2008 Jul; 69(3):249-57. Epub 2008 Jun 11.

For further information please contact the HPA PPS team via email on: PPSEngland@hpa.org.uk