News Archives |
Volume 3 No 24; 19 June 2009
- MRSA bacteraemia, and Clostridium difficile mandatory reports
- Study highlights poor egg hygiene in UK restaurants and takeaways
- Influenza A(H1N1v): UK situation at 19 June 2009
MRSA bacteraemia, and Clostridium difficile mandatory reports
Meticillin-resistant Staphylococcus aureus (MRSA) bacteraemia and Clostridium difficile infection data have been published (18 June, 2009) as part of the Department of Health's mandatory surveillance programme for healthcare-associated infection. Newly published data include:
- Quarterly (January to March, 2009) counts of MRSA bacteraemia, by trust
- Quarterly (January to March, 2009) counts of C. difficile , by age group, acute trust and primary care organisation
- Annual (April, 2008 to March, 2009) counts and rates of MRSA bacteraemia, by acute trust
- Annual (April, 2008 to March, 2009) counts and rates of C. difficile, by age group, acute trust and primary care organisation.
MRSA bacteraemia (patients of all ages) [1]
Quarterly data
Data for January to March 2009 show that 692 reports of MRSA bacteraemia were recorded between January and March 2008, which is a 2% increase on the 678 cases recorded for the previous quarter (October to December 2008). However, this represents a 29% decrease on the 970 cases reported for the corresponding quarter in 2008 (January to March, 2008).
Annual data
During financial year April 2008 to March 2009, 2932 cases of MRSA bloodstream infection were reported. This is a 34% decrease on the 4451 cases reported in financial year 2007/08. The rate of MRSA bacteraemia in 2008/09 was 0.79 cases per 10,000 bed-days, compared to a rate of 1.19 cases per 10,000 bed-days reported for 2007/08.
C. difficile (patients aged 2-64 years of age, and over 65 years) [2]
Quarterly data
There has been a 6% increase in the number of cases (8358) of C. difficile reported among all patients aged 2 years of age and over in January to March, 2009, compared to the 7908 cases reported in the previous quarter (October to December, 2008). However, this represents a 36% decrease on the number of cases (12,967) reported in the corresponding quarter of 2008 (January to March).
Annual data
For the financial year April 2008 to March 2009, 36,097 cases of C. difficile were reported for all patients aged 2 years and over, which is a 35% decrease on the 55,499 cases reported in financial year 2007/08. Reported specimens from patients aged 2-64 years represent 20% of all reports under the mandatory scheme for C. difficile infection in patients aged 2 years and over.
Note
The next quarterly data for MRSA bacteraemia and C. difficile will be published in September, 2009.
References
1. Quarterly results from the mandatory surveillance of MRSA bacteraemia: June 2009. HPA website: Staphylococcus aureus / Mandatory Staphylococcus aureus bacteraemia surveillance scheme.
2. Clostridium difficile infection Quarterly Reports: June 2009. HPA website: Clostridium difficile / Epidemiological Data / Clostridium difficile Mandatory Surveillance /Results of the mandatory Clostridium difficile reporting scheme. .
Study highlights poor egg hygiene in UK restaurants and takeaways
Poor hygiene practices in the use of pooled egg mixes in restaurants, takeaways, bakeries, cafés and sandwich bars across the UK have been identified following an investigation carried out by the Local Authorities Coordinators of Regulatory Services (LACORS) and the HPA [1].
The investigation was concerned specifically with the incidence of salmonella contamination in catering premises using pooled, raw, shelled egg mixes (RSEM) as an ingredient in lightly cooked or uncooked foods, a practice particularly common in premises serving Chinese cuisine. Hygiene practices in the handling of RSEM - particularly the potential for cross-contamination from RSEM within ready-to-eat food preparation areas - were also investigated in the 934 premises visited between May and October 2008 .
Although the incidence of salmonella detected was restricted to a small proportion of premises - salmonella was found in 0.13% (1/764) of RSEM, 0.3% (2/726) of environmental swabs and 1.3% (7/550) of cleaning cloths sampled - the joint HPA/LACORS report on the investigation refers to widespread lack of awareness of food safety management precautions appropriate to the use of RSEM.
For example, poor storage and handling practices were widespread among the premises visited:
- 40% failed to use designated utensils when RSEM was added to other ingredients during food preparation;
- 17% did not clean surfaces and utensils thoroughly after they had been used with
- RSEM and before preparing other ready-to-eat foods;
- 43% of staff did not wash and dry hands after handling eggs or RSEM;
- 41% did not store RSEM at refrigeration temperature before use;
- 8% added RSEM to cooked rice at the end of cooking when preparing egg fried rice.
Lack of awareness of key food safety requirements was particularly absent among operators of take-away premises, and specifically those serving Chinese cuisine. All caterers using RSEM need to be aware of the continuing hazards associated with the product and have in place sufficient controls to minimize the risk to human health. Practical advice for caterers handling eggs is available in a Food Standards Agency leaflet [2] and in the guide, Safer Food Better Business [3]
References
1. HPA/LACORS. Microbiological study on salmonella contamination of pooled raw shelled egg mix and environmental samples from catering establishments. Downloadable from the HPA website at Food Sampling/HPA LACORS Reports.
2. Food Standards Agency. Eggs - what caterers need to know. http://www.food.gov.uk/multimedia/pdfs/eggleaflet.pdf.
3. Food Standards Agency. Safer Food, Better Business. http://www.food.gov.uk/foodindustry/regulation/hygleg/hyglegresources/sfbb/sfbbcaterers/.
Influenza A(H1N1v): UK situation at 19 June 2009
During the week-ending Friday 19 June, the eighth week of the UK outbreak, the number of confirmed UK cases of infection with the novel, swine-lineage influenza virus A/H1N1 rose to 1984, representing a doubling of the cumulutive total for the second consecutive week. The total of confirmed cases in England (see qualifying footnotes to table 1) was 1431 (compared with 574 in the previous week). Northern Ireland saw a small rise to 13 (compared with seven cases in previous week) with no change in Wales (three laboratory confirmed cases) [1].
Table 1: Confirmed cases by Region and Devolved Administration, United Kingdom as reported by 19 June 2009
Region where sample |
Confirmed cases at 19 June (at 12 June) |
East of England |
72 (47) |
East Midlands |
18 (13) |
London |
338 (140) |
North East |
26 (18) |
North West |
35 (19) |
South East |
127 (79) |
South West |
23 (14) |
West Midlands |
748 (229) |
Yorkshire & Humberside |
44 (15) |
Total England |
1431** (574) |
Northern Ireland |
13 (7) |
Scotland |
537*** (337) |
Wales |
3 (3) |
TOTAL UK |
1984 (921) |
Assumed mode of transmission in the UK
A fourth out-of-season Weekly National Influenza Report [3] for the UK was published, indicating that at 17 June (week 25), of the 1582 cases confirmed in the UK at that time:
- 210 were assumed to have acquired the virus abroad;
- 696 were assumed to have acquired the virus in the UK of which 42 were thought to be sporadic cases (no known travel history or contact with a known case); and
- the determination of the route of transmission was pending in 676 cases.
References
1. "Update on confirmed swine flu cases", (HPA press release of 19 June 2009). HPA website: National Press Releases.
2. "Situation report Influenza A(H1N1) in Scotland as at 12 noon on Thursday 18 June 2009". Health Protection Scotland website: http://www.hps.scot.nhs.uk/news/spdetail.aspx?id=262.
3. "HPA Weekly National Influenza Report", 17 June 2009 (week 25). HPA website: Swine Influenza Epidemiological Data. The Weekly National Influenza Report can be received by e-mail by registering a name and e-mail address at: respcdsc@hpa.org.uk.