Dáil Éireann Debate, Thursday - 13 February 2014
276. Deputy Bernard J. Durkan asked the Minister for Health the extent to which the incidence of MRSA or other similar hospital infections continues to be monitored; the extent to which improvement has taken place in each of the past five years to date; and if he will make a statement on the matter. [7388/14]
View answerThe prevention of Healthcare Associated Infections (HCAIs) and colonisation/infection of our patients with antimicrobial-resistant organisms (AMR) such as MRSA is one of my priorities in protecting patient safety. HCAIs represent a major cause of preventable harm and increased healthcare costs. While not all HCAIs are due to AMR a significant proportion are. HCAIs are not an inevitable consequence of healthcare - recent evidence suggests that up to 70% of HCAIs can be prevented depending on the type of infection and the baseline rate.
The approach to prevention and control of HCAIs is similar irrespective of whether or not it is caused by an antibiotic resistant bacteria. Therefore, the Health Service Executive (HSE) has a dual focus:
1. Implementing measures to prevent and control HCAIs including those caused by AMR such as MRSA
2. Implementing specific measures for AMR including MRSA
- These are outlined in national guidelines which have been recently updated
- Monitoring infections caused by AMR as outlined later in this response.
The HSE has implemented a number of national initiatives in this field for many years, including:
- SARI 2001-2010 which specifically outlined the national strategy for prevention of AMR and was launched by the Minister of Health in 2001.
- HSE ‘ Say No to Infection’ which focused on both HCAIs and AMR
- The RCPI & HSE national clinical programme for the prevention and control of HCAIs and AMR which commenced in late 2010.
- Public reporting of HCAIs and AMR in Irish acute hospitals:
- HCAIs Prevalence Study 2006 and 2012
- S. aureus bloodstream infection (reported quarterly since 2007) – this includes public reporting of MRSA rates per hospital
- Alcohol hand rub consumption (reported bi-annually since 2007)
- Antibiotic consumption (reported bi-annually since 2007)
- Hand hygiene compliance (reported bi-annually since 2011)
The overall aim of the national clinical programme for the prevention and control of HCAIs and AMR is that every healthcare worker and all parts of the healthcare system recognise that the prevention and control of HCAIs and AMR is a key element of clinical and non-clinical governance. Our healthcare systems have processes in place to ensure safe healthcare is reliably delivered irrespective of the healthcare setting. The programme focuses on getting three basic practices right every time we care for our patients, these are hand hygiene, using antimicrobials appropriately (antimicrobial stewardship) & preventing medical device-related infections i.e., IV lines/drips, urinary catheters. If the above three measures are applied consistently and reliably every time healthcare workers care for their patients/residents/client then a significant proportion of HCAIs, including that caused by AMR will be prevented.
The Health Protection Surveillance Centre (HPSC) collates information from hospitals on healthcare associated infections and antimicrobial resistant organisms such as MRSA. Information is also published on an ongoing basis for S. aureus and MRSA bloodstream infection – published quarterly to hospital level since 2007. Notably, there has been an annual decrease in reported S. aureus BSI, from 1,251 (2010) to 1,060 (2012). To the end of Q1 2013, 18.6% were due to resistant S. aureus (MRSA), a reduction on 2012 (22.8%).
In December last I launched and endorsed the second National Clinical Guideline, Prevention and Control Methicillin-Resistant Staphylococcus aureus (MRSA). This National Clinical Guideline provides practical guidance on prevention and control measures for MRSA to improve patient care, minimise patient morbidity and mortality and to help contain healthcare costs. The guideline has been developed for all healthcare staff involved in the care of patients, residents or clients who may be at risk of or may have MRSA in acute hospitals, obstetrics and neonates, nursing homes/long stay residential units and the community.
While I welcome the reducing trend in reported rates of MRSA in Ireland which indicates an overall reduction of 59% in MRSA rates since 2006, as per the table, Ireland’s MRSA rates are comparably high with other countries. We must systematically build our actions and processes to continue to reduce the prevalence of MRSA in Ireland. I might add that I have ensured that Patient Safety has been made a priority within the HSE's Annual Service Plan through specific measures focused on quality and patient safety including HCAIs, Medication safety and implementation of Early Warning Score systems. My officials meet the HSE each month on the Service Plan and patient safety is a standing item on that agenda.
|
Year |
No. of MRSA cases |
Decrease |
|
2006 |
592 |
- |
|
2007 |
536 |
- |
|
2008 |
439 |
- |
|
2009 |
355 |
- |
|
2010 |
305 |
- |
|
2011 |
263 |
- |
|
2012 |
242 |
59% decrease on 2006 figures |
|
2013 |
180* |
* Data provisional to the end of Q3 2013 |
