THERE WERE more cases of MRSA bloodstream infection reported by Dublin's St James's Hospital than by any other hospital in the State last year, new figures show, writes Eithne Donnellan.
The figures, collated by the Health Protection Surveillance Centre, indicate 61 patients were detected with MRSA bloodstream infections in the hospital last year. This compared with 50 at Dublin's Beaumont Hospital, 40 at the Mater hospital, 39 at Cork University Hospital and 30 at University College Hospital Galway.
The centre, in its report on the infections published yesterday, said most of the variation in reported MRSA bloodstream infections between hospitals can be explained by differences in hospital size, activity and patient populations. "At present there is no way to adjust the data to allow for these differences and hence direct comparisons between hospitals are not possible," it said.
St James's Hospital is the largest hospital in the State with close to 1,000 beds and the fact that most cases were reported there is therefore not surprising.
Furthermore, the report indicates that when the number of bed days used at St James's in 2007 is compared with the hospital's MRSA bloodstream infection figures, the rates of infection at the hospital per 1,000 bed days used are actually lower than in several other hospitals such as Beaumont, the Mater, Mayo General, Bantry General and Nenagh hospital.
In fact, while just 10 cases of MRSA bloodstream infections were reported by Nenagh hospital last year, it had a higher number of infections per 1,000 bed days used than any other hospital.
Nenagh used 26,756 bed days in 2007 compared to the 300,653 used by St James's.
In a statement, St James's said it was inappropriate to compare the number of patients with MRSA bloodstream infection in different hospitals. "The report gives a number of reasons why comparisons should not be made," it said.
Overall, the centre's report says there was a slight drop in the number of cases of MRSA bloodstream infections detected in Irish hospitals last year but it says the drop was not "statistically significant". The number of cases dropped from 572 in 2006 to 526 in 2007.
In addition, the report stresses that the fact a patient is diagnosed with a bloodstream infection at a given hospital does not indicate that 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," it said.
It also says hospitals that test more often for MRSA are more likely to diagnose infections.
MRSA can be fatal if it enters the bloodstream through open wounds. A number of inquests over the past year have returned verdicts of death as a result of MRSA infection.
No data on cases of Clostridium difficile infection, which has also killed patients, is included in the report.
The report says overall level of antibiotic consumption in hospitals was higher in 2007 than 2006.