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Hospital Acquired Infections

Dáil Éireann Debate, Tuesday - 14 February 2012

Tuesday, 14 February 2012

Questions (664, 665)

Patrick Nulty

Question:

715 Deputy Patrick Nulty asked the Minister for Health the frequency and location of MRSA infections in hospitals reported for each year for the past five years to date in 2012; the steps that have been taken to reduce the occurrence of the virus; if a reduction has been achieved; and if he will make a statement on the matter. [8189/12]

View answer

Patrick Nulty

Question:

716 Deputy Patrick Nulty asked the Minister for Health the frequency and location of norovirus infections in hospitals reported for each year for the past five years to date in 2012; the steps that have been taken to reduce the occurrence of the virus; if a reduction has been achieved; and if he will make a statement on the matter. [8190/12]

View answer

Written answers

I propose to take Questions Nos. 715 and 716 together.

A table showing the data on Staphylococcus aureus/MRS bloodstream infection from acute hospitals (public and private) for the past five years follows. The information is taken from a report by the Health Protection Surveillance Centre (HPSC) which is available on their website. The Table shows that there has been a decrease of 43% in the number of MRS cases reported between 2007 and 2010.

The control of Healthcare Associated Infections (HCAIs) continues to be a policy priority for my Department and the Health Service Executive (HSE) and a number of initiatives have been taken in the last few years aimed at reducing the incidence of HCAIs. National Infection Control Action Plan was launched by the HSE in 2007, aimed at reducing HCAIs by 20%, MRS infection by 30% and antibiotic consumption by 20%. National Standards for the Prevention and Control of HCAIs were published by HIQA in May 2009 and the process of implementation by the HSE is ongoing. Hand hygiene is an important factor in the control of HCAI's. The HSE continues to encourage good hand hygiene among its staff and monitors the level of compliance with hand hygiene standards across the hospital system.

In relation to norovirus infections, data on the frequency of occurrence by hospital for the past 5 years is not available. There is no requirement to report hospital name or location of outbreaks in relation to norovirus to the HPSC. The HPSC, does however, collect the number of confirmed norovirus outbreaks in acute hospital settings, by region, each year. These are set out in the table which shows the total number of outbreaks and a geographical breakdown of the location.

In 2003, National Guidelines on the Management of Outbreaks of Norovirus Infection in Healthcare settings was produced to address the issue of hospital and other healthcare settings. In 2002 the average size of norovirus outbreaks in Irish hospitals was about 100 cases. Average hospital outbreak size fell to about 28 cases by 2006. In 2011, the average size of norovirus outbreaks in hospital has reduced again to 22, a clear indication of the improved capacity within the acute sector to rapidly control norovirus outbreaks. It should be noted that norovirus is highly transmissible and what is seen in hospitals is simply a reflection of generalised norovirus activity in the community rather than a reflection on the hygiene conditions in any particular hospital. The reason hospitals figure so prominently in norovirus data is that outbreaks are more likely to be identified and managed in hospitals than in any other setting. In addition, people ill with norovirus are more likely to present to hospital hence inflating the figures.

Appendix 4. Annual summary of Staphylococcus aureus/MRSA data by hospital, 2007-2011(Q3)

Data correct as of 14/12/2011

Year

2007

2008

2009

2010

2011(Q1-3) †

Hospital Name

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

Adelaide, Meath and National Children’s Hospital, Tallaght

61

18

29.5%

0.097

80

27

33.8%

0.141

61

14

23.0%

0.074

62

12

19.4%

0.064

38

6

15.8%

0.043

Aut Even Hospital, Kilkenny

1

0

0.0%

*

2

2

100.0%

*

1

1

100.0%

*

1

0

0.0%

*

1

0

0.0%

*

Bantry General Hospital

11

8

72.7%

0.307

5

1

20.0%

0.037

5

3

60.0%

0.124

11

7

63.6%

0.392

8

0

0.0%

0.000

Beacon Hospital, Sandyford

3

0

0.0%

*

0

0

0.0%

*

5

0

0.0%

*

8

2

25.0%

0.055

8

3

37.5%

0.095

Beaumont Hospital

127

50

39.4%

0.222

110

45

40.9%

0.198

103

20

19.4%

0.086

93

22

23.7%

0.097

83

23

27.7%

0.142

Blackrock Clinic

12

3

25.0%

*

6

0

0.0%

*

3

0

0.0%

*

7

0

0.0%

*

4

0

0.0%

0.000

Bon Secours Hospital, Cork

10

0

0.0%

0.000

7

2

28.6%

0.031

12

1

8.3%

0.015

15

3

20.0%

0.045

6

1

16.7%

0.020

Bon Secours Hospital, Galway

2

1

50.0%

0.066

0

0

0.0%

0.000

0

0

0.0%

0.000

0

0

0.0%

0.000

0

0

0.0%

*

2007

2008

2009

2010

2011(Q1-3) †

Hospital Name

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

Bon Secours Hospital, Glasnevin

0

0

0.0%

*

2

0

0.0%

*

0

0

0.0%

*

0

0

0.0%

*

0

0

0.0%

*

Bon Secours Hospital, Tralee

4

3

75.0%

*

2

1

50.0%

*

5

0

0.0%

0.000

4

1

25.0%

0.030

5

1

20.0%

0.039

Cappagh National Orthopaedic Hospital

0

0

0.0%

0.000

0

0

0.0%

0.000

0

0

0.0%

0.000

0

0

0.0%

0.000

0

0

0.0%

0.000

Cavan General Hospital

24

9

37.5%

0.137

22

3

13.6%

0.046

19

6

31.6%

0.089

17

5

29.4%

0.071

15

2

13.3%

0.038

Children’s University Hospital, Temple St

5

0

0.0%

0.000

11

2

18.2%

0.065

8

1

12.5%

0.032

14

0

0.0%

0.000

6

0

0.0%

0.000

Connolly Hospital, Blanchardstown

28

14

50.0%

0.172

32

7

21.9%

0.089

27

8

29.6%

0.100

23

6

26.1%

0.074

11

6

54.5%

0.093

Coombe Women’s and Infant’s University Hospital

11

2

18.2%

0.034

9

1

11.1%

0.018

15

1

6.7%

0.019

21

0

0.0%

0.000

12

0

0.0%

0.000

Cork University Hospital1

128

39

30.5%

0.182

88

25

28.4%

0.116

100

27

27.0%

0.125

73

15

20.5%

0.069

62

20

32.3%

0.125

Erinville Hospital, Cork1

**

**

**

**

**

**

**

**

**

**

**

**

**

**

**

**

**

**

**

**

Galway Clinic, Doughiska

3

0

0.0%

*

6

0

0.0%

*

1

0

0.0%

0.000

5

2

40.0%

0.047

4

0

0.0%

0.000

Galway University Hospitals2

92

37

40.2%

0.161

89

47

52.8%

0.208

84

35

41.7%

0.158

79

22

27.8%

0.104

45

16

35.6%

0.102

2007

2008

2009

2010

2011(Q1-3) †

Hospital Name

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

Hermitage Medical Clinic, Lucan

0

0

0.0%

*

1

0

0.0%

*

3

0

0.0%

*

0

0

0.0%

*

1

0

0.0%

*

Kerry General Hospital, Tralee

38

16

42.1%

0.187

21

13

61.9%

0.162

21

9

42.9%

0.119

17

8

47.1%

0.106

14

5

35.7%

0.094

Kilkreene Orthorpaedic Hospital, Co. Kilkenny

0

0

0.0%

0.000

0

0

0.0%

0.000

0

0

0.0%

0.000

0

0

0.0%

0.000

0

0

0.0%

0.000

Letterkenny General Hospital

34

13

38.2%

0.129

42

19

45.2%

0.193

36

14

38.9%

0.145

39

9

23.1%

0.095

27

4

14.8%

0.057

Louth County Hospital, Dundalk

9

1

11.1%

0.028

10

4

40.0%

0.112

7

1

14.3%

0.029

0

0

0.0%

0.000

0

0

0.0%

0.000

Mallow General Hospital

8

4

50.0%

0.139

11

6

54.5%

0.230

10

2

20.0%

0.078

5

3

60.0%

0.116

3

1

33.3%

0.062

Mater Misericordiaie University Hospital

97

40

41.2%

0.221

95

34

35.8%

0.199

75

19

25.3%

0.095

92

21

22.8%

0.106

53

6

11.3%

0.043

Mater Private Hospital

5

0

0.0%

0.000

0

0

0.0%

0.000

9

0

0.0%

0.000

5

1

20.0%

0.020

1

0

0.0%

0.000

Mayo General Hospital, Castlebar

39

20

51.3%

0.226

23

8

34.8%

0.092

34

19

55.9%

0.221

26

15

57.7%

0.187

11

2

18.2%

0.035

Mercy University Hospital

27

15

55.6%

0.219

29

12

41.4%

0.192

27

3

11.1%

0.050

19

8

42.1%

0.134

12

3

25.0%

0.069

2007

2008

2009

2010

2011(Q1-3) †

Hospital Name

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

Merlin Park University Hospital, Galway2

***

***

***

***

***

***

***

***

***

***

***

***

***

***

***

***

***

***

***

***

Midland Regional Hospital, Mullingar

15

5

33.3%

0.091

23

6

26.1%

0.105

21

5

23.8%

0.087

21

4

19.0%

0.066

18

6

33.3%

0.124

Midland Regional Hospital, Portlaoise

9

3

33.3%

0.071

9

1

11.1%

0.024

10

3

30.0%

0.068

9

3

33.3%

0.069

6

1

16.7%

0.029

Midland Regional Hospital, Tullamore3

28

13

46.4%

0.207

8

12.5%

0.017

18

4

22.2%

0.065

19

8

42.1%

0.120

14

4

28.6%

0.091

Mid-Western Regional Hospital, Dooradoyle

52

16

30.8%

0.117

60

19

31.7%

0.142

54

23

42.6%

0.165

65

19

29.2%

0.138

45

12

26.7%

0.116

Mid-Western Regional Hospital, Ennis

10

3

30.0%

0.095

7

2

28.6%

0.068

2

0

0.0%

0.000

10

0

0.0%

0.000

5

2

40.0%

0.129

Mid-Western Regional Hospital, Nenagh

12

9

75.0%

0.336

4

1

25.0%

0.043

7

2

28.6%

0.101

4

1

25.0%

0.056

4

1

25.0%

0.080

Mid-Western Regional Maternity Hospital, Limerick

2

0

0.0%

0.000

2

0

0.0%

0.000

2

0

0.0%

0.000

3

0

0.0%

0.000

5

0

0.0%

0.000

2007

2008

2009

2010

2011(Q1-3) †

Hospital Name

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

Mid-Western Regional Orthopaedic Hospital, Croom

0

0

0.0%

0.000

0

0

0.0%

0.000

0

0

0.0%

0.000

1

0

0.0%

0.000

0

0

0.0%

0.000

Monaghan General Hospital4

10

3

30.0%

0.143

3

1

33.3%

0.052

2

1

50.0%

0.099

**

**

**

**

**

**

**

**

Mount Carmel Hospital, Churchtown

2

0

0.0%

*

1

0

0.0%

*

0

0

0.0%

0.000

0

0

0.0%

0.000

0

0

0.0%

0.000

Naas General Hospital

21

11

52.4%

0.151

18

6

33.3%

0.076

26

14

53.8%

0.177

20

8

40.0%

0.109

8

1

12.5%

0.018

National Maternity Hospital, Holles Street

4

0

0.0%

0.000

13

0

0.0%

0.000

9

0

0.0%

0.000

11

0

0.0%

0.000

5

0

0.0%

0.000

Other non-acute facilities

3

0

0.0%

*

12

7

58.3%

*

8

2

25.0%

*

8

2

25.0%

*

6

2

33.3%

*

Our Lady of Lourdes Hospital, Drogheda5

5

1

20.0%

0.042

15

2

13.3%

0.021

26

7

26.9%

0.077

23

1

4.3%

0.011

24

8

33.3%

0.106

Our Lady’s Children’s Hospital, Crumlin

33

4

12.1%

0.066

37

6

16.2%

0.099

35

1

2.9%

0.017

33

4

12.1%

0.067

19

3

15.8%

0.066

Our Lady’s Hospital, Cashel6

0

0

0.0%

0.000

**

**

**

**

**

**

**

**

**

**

**

**

**

**

**

**

2007

2008

2009

2010

2011(Q1-3) †

Hospital Name

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

Our Lady’s Hospital, Navan

9

6

66.7%

0.143

6

1

16.7%

0.025

11

3

27.3%

0.083

6

1

16.7%

0.028

5

1

20.0%

0.041

Portiuncula Hospital, Ballinasloe

9

3

33.3%

0.060

12

7

58.3%

0.141

9

3

33.3%

0.065

9

4

44.4%

0.085

6

1

16.7%

0.028

Roscommon County Hospital

8

3

37.5%

0.094

11

4

36.4%

0.128

3

0

0.0%

0.000

8

5

62.5%

0.175

4

1

25.0%

0.052

Rotunda Hospital

12

0

0.0%

0.000

14

0

0.0%

0.000

15

0

0.0%

0.000

10

0

0.0%

0.000

4

2

50.0%

0.049

Royal Victoria Eye and Ear Hospital, Dublin

0

0

0.0%

0.000

0

0

0.0%

0.000

1

1

100.0%

0.140

0

0

0.0%

0.000

1

1

100.0%

0.200

Sligo General Hospital

28

13

46.4%

0.147

31

10

32.3%

0.126

21

5

23.8%

0.055

35

7

20.0%

0.073

15

4

26.7%

0.057

South Infirmary/Victoria University Hospital, Cork

6

4

66.7%

0.072

13

4

30.8%

0.078

13

5

38.5%

0.098

17

7

41.2%

0.147

8

0

0.0%

0.000

South Tipperary General Hospital, Clonmel

8

1

12.5%

0.013

17

5

29.4%

0.064

16

6

37.5%

0.082

10

4

40.0%

0.056

13

4

30.8%

0.080

St Columcille’s Hospital, Loughlinstown

22

8

36.4%

0.187

14

4

28.6%

0.095

15

5

33.3%

0.119

9

0

0.0%

0.000

6

0

0.0%

0.000

St Finbarr’s Hospital, Cork1

4

3

75.0%

0.113

**

**

**

**

**

**

**

**

**

**

**

**

**

**

**

**

St James’s Hospital

125

61

48.8%

0.203

96

31

32.3%

0.106

93

29

31.2%

0.098

90

22

24.4%

0.077

48

12

25.0%

0.055

2007

2008

2009

2010

2011(Q1-3) †

Hospital Name

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

St John’s Hospital, Limerick

5

2

40.0%

0.078

2

0

0.0%

0.000

6

2

33.3%

0.099

8

2

25.0%

0.093

3

2

66.7%

0.128

St Luke’s Hospital, Kilkenny

20

10

50.0%

0.114

12

4

33.3%

0.048

25

4

16.0%

0.048

15

2

13.3%

0.025

13

2

15.4%

0.032

St Luke’s Hospital, Rathgar

3

2

66.7%

0.045

7

2

28.6%

0.045

11

2

18.2%

0.049

4

1

25.0%

0.023

2

0

0.0%

0.000

St Mary’s Orthopaedic Hospital, Gurranebraher

0

0

0.0%

0.000

1

0

0.0%

0.000

1

0

0.0%

0.000

0

0

0.0%

0.000

0

0

0.0%

0.000

St Michael’s Hospital, Dun Laoghaire

4

2

50.0%

0.077

5

0

0.0%

0.000

11

1

9.1%

0.035

5

3

60.0%

0.123

7

1

14.3%

0.057

St Vincent’s Private Hospital

9

3

33.3%

0.065

11

4

36.4%

0.089

9

1

11.1%

0.023

8

0

0.0%

0.000

7

0

0.0%

0.000

St Vincent’s University Hospital, Elm Park

69

28

40.6%

0.158

70

28

40.0%

0.165

79

22

27.8%

0.134

74

13

17.6%

0.079

58

19

32.8%

0.155

University College Hospital, Galway2

***

***

***

***

***

***

***

***

***

***

***

***

***

***

***

***

***

***

***

***

2007

2008

2009

2010

2011(Q1-3) †

Hospital Name

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

SAU number

MRSA number

% MRSA

MRSA rate per 1,000 bed days used

Waterford Regional Hospital

54

26

48.1%

0.182

48

19

39.6%

0.129

49

12

24.5%

0.087

48

14

29.2%

0.101

35

14

40.0%

0.135

Wexford General Hospital

13

0

0.0%

0.000

18

5

27.8%

0.065

30

8

26.7%

0.114

32

8

25.0%

0.122

16

3

18.8%

0.060

Total ROI

1393

536

38.5%

0.135

1303

439

33.7%

0.110

1309

355

27.1%

0.089

1251

305

24.4%

0.078

840

206

24.5%

0.070

† Data for 2011 provisional to the end of Q3.

*Denominator data (Activity/BLC numbers) not provided.

**No longer classified an acute hospital — see note below.

***See note below.

1In 2007, maternity services at Erinville Hospital and St Finbarr’s Hospital, Cork transferred to Cork University Maternity Hospital, which together with Cork University Hospital (CUH) compose CUH group. All data for CUH group as of 2007 are presented under Cork UH.

2University College Hospital, Galway and Merlin Park University Hospital incorporated as Galway University Hospitals as of January 2008.

3No data from Midland Regional Hospital, Tullamore for 2006 or for the period Q3-4 2008: activity data (bed days used and inpatient admissions) adjusted accordingly.

4In Aug 200, acute services at Monaghan General Hospital ceased.

5No data from OLLH, Drogheda for 2006 or for the period Q1-3 2007: activity data (bed days used and inpatient admissions) adjusted accordingly.

6In Jan 2007, acute services at Our Lady’s Hospital, Cashel transferred to South Tipperary General Hospital, Clonmel.

Data in the shaded area represent updates from previous reports.

Note: National rates are calculated only where both numerator (e.g. numbers of isolates) and denominator (e.g. numbers of bed days used) data are available.

Health Protection Surveillance Centre (HPSC)

Confirmed norovirus outbreaks in acute hospital settings by region

HSE Region

2006

2007

2008

2009

2010

2011

East

22

11

9

8

10

6

Midland

12

4

3

2

5

4

Mid-West

5

6

6

6

3

6

North East

5

5

9

4

4

6

North West

9

1

10

3

2

2

South East

9

11

4

5

7

10

South

14

6

8

4

6

3

West

4

4

6

2

10

8

Total

80

48

55

34

47

45

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