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MRSA bloodstream infections down but c difficile figures up

Latest figures for MRSA show there was a 6.4% fall in the number of cases of blood stream infection reported to the Health Protection Agency from January - March 2007. There were 1,444 cases reported in England compared to 1,542 in the last quarter In January 2007, the agency started publishing quarterly surveillance figures on healthcare associated infection to help hospitals improve the responsiveness of their efforts to reduce infections.

These latest quarterly figures complete the full year's picture of MRSA bloodstream infections which have fallen by 10% over the course of the year. Between April 2006 - March 2007, 6,378 cases of MRSA bloodstream infections were reported, compared to 7,096 for the previous year. The biggest falls have been seen in London which previously had the highest number of cases, and in acute teaching trusts.

Dr Georgia Duckworth, head of the agency's healthcare associated infection & antimicrobial resistance department, said: “ Certain hospitals have made great strides in bringing down their levels of MRSA bloodstream infection, for example, by targeting interventions at risk areas and procedures, such as indwelling devices. As a result they have managed to achieve significant reductions in the number of infections.

“Today, we have also published some preliminary information from an extension to the MRSA bloodstream infection surveillance scheme. The information shows that MRSA occurs more frequently in the elderly, with more than 77% of cases reported in those 60 years and over. This group may be particularly at risk from MRSA bloodstream infections since many of them experience both prolonged hospital stays and admission to specialist units. “

The latest c lostridium difficile figures, also published today by the Health Protection Agency, show that there were 15,592 cases in patients aged 65 years and over in England reported in the first quarter of 2007. This represents a 2% rise when compared to the same period last year, January - March 2006, but is 22% higher than the previous quarter; however higher numbers of vulnerable people are admitted to hospital during this time of year which may explain this rise.

Dr Christine McCartney, who leads the agency's programme for healthcare associated infections, said: “The agency has been actively supporting and advising NHS trusts to help them bring down their levels of healthcare associated infections, and the continuing fall in the numbers of MRSA cases is very encouraging. However there is still a lot of work to be done if we are to continue to achieve reductions in both MRSA bloodstream infections and c difficile. Many of these infections are preventable if hygiene and antibiotic prescribing guidelines are strictly followed by trusts.”

Gill Morgan, chief executive of the NHS Confederation, said:

“It is clear that a great deal of progress has been made in tackling healthcare associated infections. Any HCAI is an extremely serious matter and it should also be emphasised that these figures represent a very small proportion of the 10 million inpatients that the NHS treats in hospitals every year.

“The NHS is committed to solving this problem and it is encouraging that the greatest progress in tackling MRSA has been made in those areas that previously had the highest rates of infection. In a similar way, the NHS is now much better at detecting cases of c. difficile which may have resulted in the rise in reported cases. Furthermore, the rate of increase in c. difficile is slowing.

“Nevertheless, we should of course be aiming for zero infections from HCAIs and the extra £50 million that the Department of Health is investing to tackle MRSA and c. difficile is to be welcomed.

“HCAIs are widely recognised as an intractable problem for the NHS and the solutions will need everyone – including the local community – to work together. We must be vigilant about hygiene standards at all times – and this is especially the case amongst the most vulnerable groups such as the elderly. It is within this context that we must view and deal with the issue.”

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