Dáil Éireann Debate, Thursday - 19 February 2009
39 Deputy Bernard J. Durkan asked the Minister for Health and Children the number of cases of MRSA and Clostridium difficile infection reported or confirmed in each of the past five years to date; the action taken or proposed to address this issue; and if she will make a statement on the matter. [6576/09]
View answer127 Deputy Bernard J. Durkan asked the Minister for Health and Children the extent to which she has taken steps to reduce the incidence of MRSA infection in both public and private hospitals; and if she will make a statement on the matter. [6885/09]
View answer128 Deputy Bernard J. Durkan asked the Minister for Health and Children the number of incidents of MRSA infection recorded in respect of both public and private hospitals in the past 12 months; and if she will make a statement on the matter. [6886/09]
View answer129 Deputy Bernard J. Durkan asked the Minister for Health and Children if she is satisfied that the steps taken to control MRSA and Clostridium difficile are adequate and effective in reducing the incidence of infection; and if she will make a statement on the matter. [6887/09]
View answerI propose to take Questions Nos. 39 and 127 to 129, inclusive, together.
Tackling Health Care Associated Infections (HCAIs), including MRSA and Clostridium difficile (C. difficile), continues to be a priority for the Government and the Health Service Executive (HSE). HCAIs are not a new phenomenon and have always been a potential complication of medical treatment, especially in hospitals. This is the case worldwide.
At a European level, the European Antimicrobial Resistance Surveillance System (EARSS) was established in 1999 to inform national and International efforts in tackling antimicrobial resistance in Europe. As part of this system, the HSE collects data on invasive isolates of Staphylococcus aureus from microbiology laboratories in hospitals throughout Ireland. The participating laboratories represent both public and private hospitals and other health care institutions. As of January 2009, 42 microbiology laboratories in Ireland participate in EARSS representing 98% coverage of the Irish population.
The number of MRSA bloodstream infections recorded in the past five years are — 553 cases in 2004, 592 cases in 2005, 588 cases in 2006, 537 cases in 2007 and 342 cases in the first 9 months of 2008. Similar data is not available on C. difficile for these years. However, since May 2008, C. difficile has become a notifiable disease. The prevalence identified for this condition in the Third Prevalence Survey of Health Care Associated Infections in acute hospitals in 2006 was 0.5% of patients studied. The number of cases reported from May to December 2008 is 1607 and is consistent with the prevalence in the 2006 survey.
As the Deputy will be aware, the HSE launched a National Infection Control Action Plan in March 2007. The HSE aims to reduce HCAIs by 20%, MRSA infection by 30% and antibiotic consumption by 20% over a 5 year period.
A new National Surveillance System has been established to collect data and provide information on HCAIs in our health system. This data covers four key areas:
1. Staphylococcus aureus bacteraemia (bloodstream infection);
2. Antibiotic consumption;
3. Alcohol gel use; and
4. From 2008 onwards, MRSA incidence in Intensive Care Units.
The results so far show some improvement. The overall proportion of MRSA was lower in 2007 (38.5%) compared to 2006 (42.4%) and the most recent figures show that MRSA infections for the first nine months of 2008 have fallen by 3.8% compared with the same period in 2007 and 7.2% when compared with 2006.
The overall acute in-patient antibiotic consumption rate increased slightly in 2007 over the 2006 rate by 2.4%. Overall alcohol gel use is up by a significant 50%. The results provide a good benchmark into the future to enable us to measure effectively the progress of each hospital on their performance in infection prevention and control.
The Health Protection Surveillance Centre of the HSE published Guidelines for the Surveillance, Management and Control of C. difficile-associated diseases in May 2008. This publication gives national guidance and deals with the isolation of C. difficile ribotype 027 for the first time in Irish hospitals. The guidelines will be a valuable resource in assisting in the prevention, management and control of this infectious disease.
Other measures taken to reduce the incidence of HCAIs generally include the appointment of additional infection control staff, education campaigns for health care staff and the general public around the prudent use of antibiotics, and the use of designated private beds for isolation purposes where required for patients who contract HCAIs. In addition, new environmental building guidelines to inform infection control policy in all new builds and refurbishments have recently been agreed by the HSE and will be published shortly.
I am satisfied that significant steps are being taken to reduce the rates of HCAIs generally and to treat them promptly when they occur.
