Annual figures released by the Health Protection Agency paint a mixed picture of progress in the fights against healthcare-associated infections; while the prevalence of MRSA continues to fall, rates of Clostridium difficile are still on the rise.

The latest yearly figures for methicillin-resistant Streptococcus aureus show a 10% decrease in the last year, with 6,381 cases reported in England between April 2006 and March 2007, compared to 7,096 for the prior year.

However, annual cases of C. difficile infections in patients aged 65 years and over climbed 7% between 2005 and 2006 to 55,620, although the rate has slowed from the 16% jump recorded between 2004 and 2005.

On the plus side, the latest quarterly figures (April to June 2007) for C. difficile show a 13% drop to 13,660 cases, which could indicate a that its prevalence is reaching a plateau. MRSA infections were also down for the quarter, falling 10% to 1,303 incidences.

Commenting on the figures, Professor Pete Borriello, Director of the Centre for Infections, said that they “show a continuing downward trend in MRSA blood poisoning infections. However, more work needs to be done to see the same level of decrease with C. difficile, and we are encouraging Trusts to use the figures to raise the profile of local infection control practices and make changes where the results indicate this may be necessary.”

Dr Gill Morgan, chief executive of the NHS Confederation, said that hospitals must “continue to focus on reducing rates of infections through raising board-level awareness and involvement, good antibiotic and isolation policies, high standards of cleanliness and staff training.”

The Confederation is currently looking at the outcome and learning from inspections and good practice with a view to producing a set of recommendations for NHS organisations and the government on how to improve the system, she added, and stressed that initiatives such as deep cleaning – as proposed by the government in last month – “need to be part of a system-wide approach to tackling this problem.”

MRSA fatalities had short life expectancies
Meanwhile, the Health Protection Agency and the Office for National Statistics have published research that found that most patients who died following MRSA infection had “significant underlying chronic medical conditions and had short life expectancies, irrespective of their MRSA infection”.

But the two year confidential study, commissioned by the Department of Health, also revealed that, out of 38 patients who had died within 30 days of an MRSA bloodstream infection, the superbug was found to be the main or contributing cause of death in 22 cases.

It also found that the most frequently identified source of MRSA infection was via invasive devices, particularly intravenous drips and/or catheters.

Dr Georgia Duckworth, the principal investigator for the study at the Agency, said the report has identified “some areas where procedures should be more rigorous, such as the management of IV drips and compliance with MRSA screening policies.”

She concluded that the study “highlights several areas of patient care requiring further attention from clinicians and policymakers to minimise the likelihood of patients acquiring an MRSA infection or subsequently dying as a result of the infection.”

New watchdog

At the end of last month, the government announced that it has set up a new watchdog tasked with gaining control over the spiralling number of healthcare associated infections in the country.

The new regulator for health and adult social care services - The Care Quality Commission - will work to provide the public with “good quality and safe care” in both the National Health Service and independent sector.

“Despite progress, tackling infection remains a challenge for the NHS,” Health Secretary Alan Johnson admitted, and promised that the new Commission will “ensure that all patients receive a safe and quality service, no matter what part of the system they are accessing, and at which point.”