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Final Issue: Volume 16 Number 51
Published on: 21 December 2006
Final Issue in PDF
Last updated: Volume 15, No.25 (PDF file, 420 KB)
The results for the first four years of the Department of Health’s mandatory Staphylococcus aureus (including MRSA) surveillance system in acute Trusts in England have been published on the Department of Health and Health Protection Agency websites.
MRSA bacteraemia numbers and rates by individual Trusts are now available for each six month period from October 2005 to March 2005, on the Department of Health website at: (www.dh.gov.uk). The Health Protection Agency’s website contains a summary of the national and regional reports submitted to the HPA on behalf of the Department of Health (http://www.hpa.org.uk/infections/topics_az/staphylo/data.htm). There is also a report on the first four years of the S. aureus mandatory surveillance scheme in this issue of CDR Weekly (see Bacteraemia section).
Saving Lives Launch
The Department of Health have launched a new delivery programme to reduce healthcare associated infection (HCAI) including MRSA.
The strategy includes a delivery programme aiming to support NHS Trusts in reducing healthcare associated infections such as MRSA, which emphasises the changes in the acute hospital setting as a priority area. The programme is designed to help Trusts embed infection control across each ward, department or unit, through the use of clinical interventions and an action planning tool. There are five high-impact interventions at the heart of the programme. These are simple evidence based tools that reinforce the practical actions clinical staff need to take to significantly reduce HCAI.
Further information on Saving Lives can be found at:
Public Accounts Committee Report: Improving Patient Care by Reducing the Risk of Hospital Acquired Infection
The House of Commons’ Committee of Public Accounts has published the report Improving Patient Care by Reducing the Risk of Hospital Acquired Infection: a progress report. This examined the progress made by the Department of Health and NHS Trusts in reducing the risks of hospital acquired infection since the original report by the Controller and Auditor General on this topic in 2000. The Committee is critical of progress made in implementing many of its predecessor’s recommendations in terms of extending surveillance of hospital acquired infection, ward cleanliness, compliance with hand hygiene improving isolation facilities, and reducing bed occupancy rates.
Further information on this Public Accounts Committee report can be found at
The Northern Ireland Department of Health, Social Services and Public Safety (DHSSPS) has published a major strategic report to co-ordinate, underpin and enhance arrangements for the prevention and control of healthcare associated infections (HCAI), particularly those associated with hospitals.
The report builds on a range of initiatives which had been undertaken in recent years in Northern Ireland and which have included: Controls Assurance Standards in infection control; the introduction of mandatory surveillance of MRSA bacteraemia, Clostridium difficile and orthopaedic surgical site infection; and the development of infection control training materials. Development of the strategy involved evaluating current regional and Trust HCAI surveillance programmes and consultation with front line clinical staff, Trust medical directors, infection control teams, Consultants in Communicable Disease Control, Directors of Public Health and the Health and Social Services Councils who represent the interests of the public. The strategy was also informed by approaches taken by the other United Kingdom health departments and evidence of good practice from elsewhere.
Key elements in the strategy:
The strategy has been issued for a three month public consultation period and is available from the DHSSPS website at < http://www.dhsspsni.gov.uk/publications/2005/prevention-of-HCAIs.pdf >.
1.European Academies Science Advisory Council. Infectious diseases – importance of co-ordinated activity in Europe. London: The Royal Society, 2005. Available at <http://www.easac.org/publications.htm#pubs>.
Between 14 and 28 May 2005, one member of staff and seven of 35 residents of an old people’s residential care home developed respiratory infections with fever and respiratory symptoms. Four residents subsequently died. The Health Protection Unit (HPU) was informed on 1 June 2005 and investigated the incident with the assistance of local general practitioners, environmental health officers and the medical microbiologist from the local acute Trust.
Three residents had urine tests for legionella and pneumococcal serology. All three tested negative for Legionella antigen and two tested positive for pneumococcal antigen, suggesting that the organism causing the infections was the bacterium Streptococcus pneumoniae.
The following case definitions were used:
Figure 1 Date of onset of respiratory illness among cases (n=14). Care home in London in May 2005
Of the 35 elderly residents, only four had previously been vaccinated against pneumococcus (including one confirmed and two possible cases). Control measures included temporary closure to new admissions while this incident was being investigated, and pneumococcal vaccination for all residents and members of staff in risk groups. Management at the care home was advised on infection control measures and information provided to staff, residents, and relatives. The last case occurred more than two weeks ago. The HPU was satisfied that all necessary control measures had been instituted and the home was allowed to reopen.
This outbreak clearly highlights the importance of vaccination for at risk communities, such as those at care homes.
1.CDC. Outbreak of Pneumococcal Pneumonia Among Unvaccinated Residents of a Nursing Home, New Jersey, April 2001. MMWR. 2001;50:707-10. Available at <http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5033a3.htm>.
2.Nuorti JP, Butler JC, Crutcher JM, Guevara R, Welch D, Holder P, et al. An outbreak of multidrug-resistant pneumococcal pneumonia and bacteremia among unvaccinated nursing home residents. N Engl J Med 1998; 338(26):1861-8. Available at <http://content.nejm.org/cgi/content/short/338/26/1861>.