MRSA bloodstream infections showing steady decrease

Britain's Health Protection Agency (HPA) has published the Annual Report on Healthcare Associated Infection 2007, as well as the latest quarterly report on the MRSA blood poisoning and Clostridium difficile (C. difficile) infection figures.

The latest annual MRSA blood poisoning figures have shown a 10% decrease in the last complete year of mandatory surveillance, with 6,381 cases of MRSA reported in England between April 2006 and March 2007, compared to 7096 between April 2005 and March 2006 .

Since mandatory surveillance of MRSA blood poisoning was introduced in 2001, there has been a 12% decrease in reported cases.

There has been a general downward trend of MRSA blood poisoning infection in all regions since September 2006. London has the largest number of MRSA blood poisoning infections, but has also seen the largest reductions. Decreases in MRSA blood poisoning infections are occurring in all types of acute NHS Trust and are most marked in acute teaching Trusts.

The Agency is also publishing the latest quarterly figures for MRSA blood poisoning today. These show that cases of MRSA blood poisoning dropped by 10% in the latest quarter, with 1,303 cases reported during April to June 2007, compared to 1,447 cases reported during January to March 2007.

Latest annual cases of C. difficile infections in patients aged 65 years and over have risen by 7% between 2005 and 2006. There were 55,620 reports of C. difficile in 2006, compared to 51,829 in 2005. This is a slower rate of increase than the 16% that was observed between 2004 and 2005.

At Trust level, the rate of C. difficile may be affected by the type of patients treated and the number of specimens processed by the Trust's laboratory from patients who are not in the Trust. These will include samples taken in areas where there are several community hospitals or nursing homes and samples taken from patients attending GPs surgeries.

The latest quarterly C. difficile figures showed a 13% drop, with 13,660 cases in patients aged 65 years or over reported in the second quarter of 2007 (April to June), compared to 15,639 cases reported during January to March 2007.

The Agency also publishes the first results for C. difficile infections in patients between 2 and 64 years of age. 2,890 cases of C. difficile were reported between April and June 2007 . As mandatory collection of this data only began in April 2007 there is currently no direct comparison possible for this age group in the mandatory surveillance. Previously data from voluntary laboratory reporting have indicated that 84% of all infections occur in the 65 years and over age group.

However these figures should be interpreted with care: as there have been recent refinements to the surveillance system that may have impacted on the figures such as the extension of the mandatory surveillance to patients aged two years and over; previously it was limited to those aged 65 and over.

Professor Pete Borriello, Director of the Centre for Infections, said: “These latest figures show a continuing downward trend in MRSA blood poisoning infections. Some NHS Trusts have made a significant impact on their MRSA infection rates, against a backdrop of increasing workloads.

However, more work needs to be done to see the same level of decrease with C. difficile and we are encouraging Trusts to use the figures to raise the profile of local infection control practices and make changes where the results indicate this may be necessary.

We hope these figures will provide a detailed picture of the challenge posed by healthcare associated infections and will play a vital role in helping hospitals measure their performance. Rates are not the same across the country with some hospitals doing an outstanding job whilst others have much to do.”

Dr Georgia Duckworth , head of the Agency's Health Care Associated Infection department, said: “It is also important to remember that not all healthcare-associated infections are preventable. However, the results in this report show that there can be, and have been, significant reductions for some infections. This is particularly notable for MRSA blood poisoning, particularly when these infections are placed in the context of significant increases in hospital activity. This is a major achievement against the seemingly unstoppable rise in MRSA bloodstream infections throughout the 1990s”.