“8% of all patients acquire an infection” - NHS Library
Hand Washing A survey carried out December 2007 revealed that:“6.6 million people in Britain do not wash their hands after going to the toilet” and “69% are not washing hands before eating”
The widely reported MRSA bacteraemia figures account for
1/3 - 1% of all hospital acquired infection.
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Welcome to our Did you know...? section
Last updated: 2 January 2010
Facts, Figures and Statistics
Here we have compiled a number of interesting articles relating to infection - in hospitals, at home and in the community.
Some of the statistics, especially those quoted from Health Protection Agency sources will give you a better understanding of the overall infection picture in the UK.
A mention in this section of any product or any manufacturer must not be construed as a recommendation.
Remember, this is a knowledge base and is intended to enhance awareness of healthcare and infections in the UK and should not be used as a substitute for professional healthcare advice.
About Bacteraemia (blood stream infections) - the only MRSA statistics you are likely to hear about
MRSA can enter the normally sterile blood stream either from a local site of infection (wound, ulcer, abscess) or any invasive device such as an intravenous catheter or cannula. Bacteraemia describes the presence of the bacteria in the blood. Septicaemia can follow and is the
clinical term for a severe illness caused by the bacteria in the blood stream.
Bacteraemia are not specific to MRSA and can be the same for other bacteria that cause septicaemia such as MSSA, E.Coli, Streptococcus, CNS and Enterococcus.
Typically symptoms can include high fever, raised white cell count, shaking, disturbance of blood clotting with a tendency to bleed and failure of vital
organs This is the kind of MRSA infection that has the highest death rate.
MRSA bacteraemia figures are being used by the government as an indicator because they are hard to treat and can have more frequent and more severe consequences than some other infections.
The widely reported MRSA bacteraemia figures account for 1/3 - 1% of all hospital acquired infection.
Bacteraemia (blood stream infections) are only the tip of the infection iceberg accounting for only 6% of all Hospital Acquired Infections.
The good news and the bad news Although cases of MRSA bacteraemia have fallen by half across the country and C. difficile rates have dropped by one third because of the excellent work carried out by some Trusts, a recent report from the
National Audit Office 2009 shows that in 12% of Trusts the MRSA rate has actually risen, The C. difficile rate has gone up in 19% of Trusts.
There are still around 3,000 cases of MRSA bacteraemia every year in British hospitals, while cases of C. diff are running at almost 3,000 a month.
In 2007, these 2 bugs alone were listed as contributing to the deaths of 9,000 patients.
Hand cleaning and hygiene protocols are dependent on staff training and awareness and it is obvious that the vital messages which can save lives are not getting through to everyone.
Hospital Acquired Infection Reporting Placing such emphasis on MRSA bacteraemia gives the public a highly unrealistic view of the overall infection picture in our hospitals. MSSA (a staph infection which is sensitive to antibiotics) is twice as prevalent and
can be just as devastating and sometimes lethal as MRSA.
MRSA bacteraemia (the statistics you hear about in the news) are a small proportion of all MRSA infections and an even smaller proportion of all staph infections.
MRSA infections, bacteraemia and non bacteraemia, account for about 26% of all orthopaedic surgical site infections (04 – 08).
MSSA infections, bacteraemia and non bacteraemia, account for about 17% of all orthopaedic surgical site infections (04 – 08).
Table: Staphylococcus aureus bacteraemia laboratory reports according meticillin susceptibility (voluntary reporting scheme):
England, Wales and Northern Ireland: 1993 - 2007. (HPA)
The table shows an overall decrease for 2007 of 5%....
....but MSSA bacteraemia account for 66% and the figures are still rising. Leslie Ash the actress was disabled by MSSA and received a settlement from the NHS of £5million and yet her case would not be included in the MRSA figures commonly published.
Although hospitals do not have to report other infections in the same way as MRSA and C. diff, the National Audit Office said evidence suggested that they were increasing and recommended much stricter surveillance.
Karen Taylor, from the NAO, said that there had been no progress on a recommendation in 2004 that all hospital infections be recorded.
Chart: Micro-organisms reported as causing SSI (all orthopaedic categories).
Four years combined (April 2004 to March 2008). (HPA)
MSSA Rates
Male
Female
Charts: Male/Female age specific Staphylococcus aureus bacteraemia vountary reporting rates and meticillin susceptibility per 100,000 population: England, Wales and Northern Ireland: January to December 2007. (HPA)
The graphs above show that the highest MSSA bacteraemia rates occur in babies up to one year.
Are men and women affected equally?
No - incidence of Staph Aureus is higher in men
- incidence of C. difficile is higher in women
Insufficient research has been carried out to determine why there are these differences but it could be any one of or a combination of many factors – physiology, anatomy, hygiene practices, cultural difference or risk perception and management.
Infection in the Community - What’s on the horizon?
Community Acquired MRSA/ PVL
Hairon, N. (2008) Emerging threats: five diseases nurses need to know about. Nursing Times; 104: 46, 55-56PVL-associated S. aureus PVL destroys white blood cells and is carried by less than 2% of S. aureus, including those that are sensitiveto the antibiotic methicillin (MSSA) andmethicillin resistant (MRSA). PVL-positive strains of S. aureus are more commonly contracted in the community and generally affect previously healthy children and young adults.
HPA report 2008 What’s on the horizon?
The rise of infections with PVL-producing strains of S. aureus in some countries, such as USA, has been causing much anxiety. Some of these strains have made the transition from causing infections in the community to spreading in hospitals. Initiatives have been taken to raise the awareness of these infections in England...
28 Nov 2007 Medical News Today The new strains of CA-MRSA appear to stick to damaged skin and airways more easily than the hospital based MRSA strains prevalent in the UK, and they reproduce more quickly.
The researchers, led by Dr Marina Morgan from the Royal Devon & Exeter Foundation NHS Trust, told delegates at the Federation of Infection Societies Conference 2007 .........that if CA-MRSA spreads in the UK as fast as it did in the US, then many patients will be admitted to hospital with a wrong diagnosis and given the wrong antibiotics, and by the time doctors realise what is happening it could be too late.
CA-MRSA is mainly spreading in the US and is a major cause of infection among American children.
As Morgan explained:
"The new community associated MRSA strains appear to be more virulent and more easily spread between people."
International Scientific Forum on Home Hygiene IFH January 2007 For family members carrying PVL-producing strains of CA-MRSA, colonisation of cuts and abrasions may result in serious and potentially fatal skin and soft tissue infections.
Community Acquired C. difficile Nearly a quarter of cases of Clostridium difficile are now being diagnosed in the community, mostly by GPs, an HPA
analysis reveals.
The Health Protection Agency researchers also estimated that half of the cases diagnosed in the community were true community-onset cases, as opposed to infections picked up in hospitals.
There is increasing incidence of Staph Aureus and C. difficile in our care homes which adds to hospital infection burden when residents are admitted to hospital.
Is your pet carrying infection? (June 22, 2009 - Insidermedicine)
“From Florida - According to research in The Lancet Infectious Diseases, MRSA may be carried by the family pet. Researchers have found that cats and dogs can be colonized by methicillin resistant Staphylococcus aureus
which can cycle back and forth between pet and owner. While petting and handling pets will not result in infection very easily, in the U.S., dog and cat bites make up about 1% of ER visits every year.”
C. difficile can also be passed on to you by your pet which is why it is important to wash your hands after pet contact.
Swine Flu
For information regarding Swine Flu, please click here to visit our Swine Flu section.
NHS Costs and Budget Changes “8% of all patients acquire an infection” - NHS Library. With 13 million admissions a year this means that nearly 1.5 million patients a year are infected.
This costs the NHS £1 billion per annum – the equivalent to the running costs of 8 NHS Hospitals
Nicholson warns of ‘unprecedented’ savings - 22 May 2009
NHS chief executive David Nicholson has warned the NHS that it may need to make “unprecedented” levels of savings from 2011 to 2014.
In his third annual report on the state of the health service, Nicholson says NHS investment will grow by 11% over the next and final two years of
the present comprehensive spending review.
But he says that “after those two years we must prepare for a range of scenarios, including the possibility that investment will be frozen for a time.”
References
Information on this website has been gathered from many reputable sources such as Government bodies, DH, NHS Trusts, Patient Groups and academic research bodies.
All sources of information can be found by following given links or by clicking on “Research” or “Research and References”
All copy and graphics subject to copyright 2009. All rights reserved.
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