MRSA Down Over 49 Per Cent In Last Three Years, UK

Main Category: MRSA / Drug Resistance
Article Date: 20 Jul 2008 - 0:00 PDT

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MRSA bloodstream infections fell by 30 per cent last year - the greatest annual reduction of the last 5 years - new figures published have shown.

The quarterly figures on healthcare associated infections published by the Health Protection Agency also show that the number of MRSA infections have fallen by over 49 per cent compared with the quarterly average in 2003/04.

The number of C.difficile infections fell by 32 per cent compared with the same quarter last year, showing significant progress. For those 65 and over, this quarter saw an expected seasonal rise, but this was only 6 per cent compared to the previous quarter, the smallest seasonal increase to date.

Secretary of State for Health Alan Johnson said:

"The significant reduction in MRSA and C. difficile infections is a remarkable achievement, the result of the hard work and dedication of NHS staff and the right investment in staff and resources.

"We are tackling infections on every front with a relentless focus on cleanliness, best practice guidance on antibiotic prescribing, isolating patients and more infection control staff with more powers to help drive down infection rates. From April 2009 frontline staff, including the 5000 matrons we have now - more than double the number of last year - will also be able to report any concerns they have to the new regulator, the Care Quality Commission.

"Our strategy is clearly having an impact, with our challenging target to reduce MRSA by half now within touching distance, but this is not an issue we can be complacent about and we will continue to focus our efforts on reducing infections further."

Notes

1. This is the greatest annual reduction in MRSA reports since the baseline period in 03/04. Full figures are set out below:

03/04 7700 (+274, +3.69%)
04/05 7233 (-467, -6.06%)
05/06 7096 (-137, -1.89%)
06/07 6383 (-713, -10.15%)
07/08 4438 (-1945, -30.47%)

2. The NHS has a target to reduce the number of MRSA infections by 50% by the end of March 2008. This will be measured against data from the next quarter (Apr-Jun 08) which will be published in October. We need to look at data for a complete quarter following the target deadline to see whether the NHS has been able to sustain the 50% reduction on average for the whole quarter following the deadline.

The MRSA target is being measured in line with other national NHS targets (A&E/cancer etc), which also measure the period immediately after the deadline.

As well as this latest quarterly mandatory surveillance data for MRSA and C.difficile, the HPA are today also publishing, as a separate document, their third annual report on surveillance of healthcare associated infections (HCAIs). This comprises HCAIs subject to mandatory surveillance (including MRSA and C.difficile) and voluntary surveillance, placing them in the context of broader surveillance of bloodstream infections and surgical site infection.

3. As part of the £270m CSR investment, £45m was identified for investment in additional staff. It is for local organisations to decide the best investment to meet their needs, but this level of funding could, for example, deliver two infection control nurses, one pharmacist and two nurses to care for patients in isolation per acute trust, alongside additional infection control nurses in every community.

4. The HPA expects to publish data for the April-June 08 quarter in the Autumn, when we will be reporting against the final target. Our targets are for actual numbers of infections not rates.

5. We have in place a comprehensive strategy to tackle healthcare associated infection. This includes:

• The number of matrons on our wards has increased to more than 5,000.
  
  
• We have issued best practice guidance to the NHS on antibiotic prescribing, isolating patients and clinical techniques to minimise the risk of infection along the patient journey.
  
  
• There are additional staff for the NHS such as infection control nurses, antimicrobial pharmacists and nurses to care for patients in isolation
  
  
• £50m has been made available to SHA Directors of Nursing in 2007/08 and the CSR funding settlement includes £270m per year by 2010/11 to tackle HCAIs
  
  
• A new bare below the elbows dress code has been introduced to support the successful hand hygiene campaign
  
  
• We have improved cleanliness across the NHS. As of May 2008, 328 trusts have completed their deep clean programmes. Following completion of this national deep clean programme, DH is working with SHAs to disseminate learning and best practice to the local NHS to enable them to determine the ongoing requirements for deep cleaning.
  
  
• Bespoke support to Trusts supplied by Department of Health Improvement Team

More information can be found at; http://www.clean-safe-care.nhs.uk

6. Deep cleaning is not different cleaning, and it does not obviate the need for thorough ongoing cleaning; instead, it is a more concentrated programme of cleaning, often using new equipment or specialist skills. It allows trusts to consider cleaning activities that are difficult to deliver, while maintaining levels of service in busy hospitals, and it addresses problems that may have built up over time.

7. For case studies on tackling healthcare associated infection visit 'Board to Ward' at: http://www.clean-safe-care.nhs.uk/public/default.aspx?load=Events

This includes case studies from Central Manchester and Manchester Children's University Hospitals NHS Trust (CMMC).

A case study from Wolverhampton Hospital can be found at: http://www.clean-safecare.nhs.uk/ArticleFiles/Files/Wolverhampton_KPIs.pdf

A Guy's and St Thomas's case study is at: http://www.clean-safe-care.nhs.uk/ArticleFiles/Files/GFF-CS2.pdf

A case study from the Princess Alexandra Hospital, Harlow is available at Appendix one to a guide to Board Assurance that can be found at: http://www.clean-safe-care.nhs.uk/ArticleFiles/Files/287717_BoardAssurance.pdf

Department of Health
http://www.dh.gov.uk