Drop in MRSA bloodstream infection cases

THE NUMBER of cases of MRSA bloodstream infection reported by hospitals across the State last year fell to 355, down from 439…

THE NUMBER of cases of MRSA bloodstream infection reported by hospitals across the State last year fell to 355, down from 439 in 2008, according to a report published yesterday.

The report from the national Health Protection Surveillance Centre (HPSC) states that although the trend in the proportion of MRSA observed in Ireland is reducing, it is still “relatively high” compared to other countries but similar to rates in the UK and southern Europe. Lowest rates are found in the Netherlands and Scandinavian countries.

While provisional figures for MRSA bloodstream infections for the whole of 2009 are provided in the report, the document only gives details of the number of MRSA bloodstream infections reported by each hospital for the first nine months of last year. During that period the largest number of cases were reported by Galway University Hospitals – 28 in all. Some 25 cases were reported by Dublin’s St James’s Hospital and 21 by Cork University Hospital.

A number of hospitals reported no cases. These included: the National Maternity Hospital, the Rotunda, Ennis General Hospital, Roscommon County Hospital, the Mid Western Regional Maternity Hospital, Croom Orthopaedic Hospital, Kilkreene Hospital, St Mary’s Orthopaedic Hospital in Cork and Cappagh Hospital in Dublin.

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The report stresses though that the fact that a patient is diagnosed with a bloodstream infection at a given hospital does not indicate the infection was acquired at that hospital. “Many bloodstream infections are acquired in the community, but only diagnosed on admission to hospital. Likewise a patient may have acquired a bloodstream infection in one hospital, but the infection may only be diagnosed on transfer to another hospital.”

Dr Robert Cunney, consultant microbiologist at the Health Protection Surveillance Centre, said the decline in infections could at least partly be explained by improvements in hand hygiene, improvements in screening and isolation of infected patients, the appointment of additional microbiologists and reduced antibiotic use in hospitals. But he cautioned the decline may have to do with “the natural evolution of MRSA”, with some strains dying out.

Every MRSA bloodstream infection reported, he said, represented a person with a potentially life threatening infection. “While there have been a lot of improvements that have had an impact we need to do a lot more,” he added.