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Last updated 15 June 2012 Volume 6, No 24 (PDF file, xxx kB)
The eleventh publication of the quarterly epidemiological commentary describes recent trends for mandatory surveillance of (MRSA) and Clostridium difficile infections (CDI) reported by NHS acute Trust hospitals in England up to March 2012 [1,2]. The publication also contains analyses of the first 15 months of meticillin-sensitive Staphylococcus aureus (MSSA) bacteraemia data and a summary of the first 10 months of Escherichia coli bacteraemia surveillance (June 2011 to March 2012). This is the second quarterly epidemiological commentary to include mandatory surveillance data on E. coli bacteraemia.
The complete epidemiological commentary with additional information on the rates of MRSA, MSSA and E. coli bacteraemia, and CDI, is available on the HPA website .
The total count of MRSA bacteraemia during the previous 10 years is shown in figure 1, and is divided into Trust apportioned episodes (this category includes patients presumed to have been infected while admitted to the Trust*) and non-Trust apportioned episodes (‘all other episodes’).
- in 2011 there were 1,185 MRSA bacteraemia reports made. This is an 83.7% reduction compared to the number of reports in 2002 (7,274) (figure 1);
- there were 504 Trust apportioned reports in 2011; representing an 83.7% reduction compared to 2006 (6,776 reports);
- there were 681 non-Trust apportioned reports (all other reports) in 2011 compared to 2,244 in 2006 representing a 69.7% reduction in non-Trust apportioned reports compared to 2006 (figure 1).
- there were 262 MRSA bacteraemia reports in the quarter January-March 2012 of which 118 and 144 were Trust apportioned and non-Trust apportioned, respectively. This represents an 86.4% decrease in reports relative to the baseline of 1,925 quarterly reports in financial year 2003/04.
Figure 1. Overview of MRSA bacteraemia reports, 2002 to 2011
- there were a total of 10,903 reports between January 2011 and March 2012. 3,569 of these reports were Trust apportioned ¥ and 7,334 were non-Trust apportioned (all other reports). An overview of reports by month is presented in figure 2.
- there were 2,157 MSSA bacteraemia reports in the quarter January-March 2012 of which 33.3% and 66.7% were Trust apportioned and non-Trust apportioned, respectively.
- Figure 2. Monthly counts of Trust apportioned and all other reports of MSSA bacteraemia, January 2011 to March 2012
E. coli bacteraemia
- of all bacteraemia covered by mandatory surveillance, E. coli is currently the most common bacteraemia with monthly reports being about 28-fold and 4-fold higher than those for MRSA and MSSA bacteraemia, respectively.
- there were a total of 26,619 E. coli bacteraemia reports between June 2011 and March 2012 (table 1). E. coli bacteraemia data is not currently being apportioned.
Clostridium difficile infection
in 2011 there were 19,130 CDI reports made. This is a 53.0% reduction compared to the number of reports in 2008 (40,705 [figure 3]);
- there were 8,418 Trust apportioned † reports in 2011 representing a 64.0% reduction in Trust apportioned reports compared to 2008 (23,085 reports [figure 3]).
- in 2011 there were 10,712 non-Trust apportioned (all other reports) CDI reports made, representing a 39.2% reduction from the number reported in 2008 (17,620). In 2010 the ratio of non-Trust apportioned reports to Trust apportioned reports was approximately 1:1 whilst in 2011 the ratio had increased to 1.3.
- data for the most recent quarter (January-March 2012) showed a total of 3,708 reports, which corresponds to a 73.3% reduction on the baseline year’s quarterly average (13,875 reports for financial year 2007/08). Of the 3,708 reports, 1,610 (43.4%) were Trust apportioned while 2,098 (56.6%) were non-Trust apportioned.
Non-Trust apportioned reports (“all other reports”): These include all reports that are NOT apportioned to an acute Trust. The two categories are mutually exclusive.
The next commentary will be published in September 2012.