Dáil Éireann Debate, Tuesday - 31 May 2005
139 Mr. Kehoe asked the Tánaiste and Minister for Health and Children if the national disease bureau records known cases of MRSA; if the data is available for the past five years; and if she will publish the figures for that period. [17939/05]
Amharc ar fhreagra164 Mr. Connolly asked the Tánaiste and Minister for Health and Children the number of cases of MRSA reported in each year since and including 2000; the steps taken to minimise instances of the infection; and if she will make a statement on the matter. [18195/05]
Amharc ar fhreagraI propose to take Questions Nos. 139 and 164 together.
MRSA, methicillin-resistant staphylococcus aureus, is a resistant form of staphylococcus aureus. The Health Protection Surveillance Centre, HPSC, formerly known as the National Disease Surveillance Centre, collects data on MRSA bacteraemia, also known as bloodstream infection or "blood poisoning", as part of the European Antimicrobial Resistance Surveillance System, EARSS. At national level, MRSA bacteraemia has been included since 1 January 2004 in the revised list of notifiable diseases under the infectious diseases regulations. The reporting process for MRSA bacteraemia remains the same for now, that is, direct reporting to the HPSC via the EARSS protocol which is done on a quarterly basis.
The number of cases of MRSA bacteraemia reported to the HPSC over the period 2000 to 2004 is as follows:
|
Year |
MRSA |
|
2000 |
249 |
|
2001 |
337 |
|
2002 |
445 |
|
2003 |
480 |
|
2004 |
553* |
*Figures for 2004 are provisional.
Provisional figures for 2004 indicate that 553 cases of MRSA bacteraemia were notified last year. However, it should be borne in mind that the number of laboratories notifying cases increased in 2004 and thus a direct comparison between these years is probably not valid as it may reflect the increased number of participating laboratories. The HPSC regularly publishes this information on its website, www.hpsc.ie.
International experience shows that the number of MRSA bloodstream infections seen in an individual hospital is generally proportional to the size of the hospital and the complexity of illnesses seen at that hospital. Thus larger hospitals treating sicker patients are more likely to see cases of MRSA bloodstream infection, compared to smaller hospitals. As can be seen from the overall number of cases reported, hospitals reporting cases of MRSA bloodstream infection will report more than one case in each quarter and this is in keeping with surveillance data from other countries.
To address the issue of antimicrobial resistance, including MRSA, the strategy for the control of antimicrobial resistance in Ireland, SARI, was launched in June 2001. Since then, approximately €20.5 million in funding has been made available by my Department under the strategy; of which approximately €4.5 million has been allocated in the current year. This SARI funding is in addition to normal hospital funding arrangements on infection control.
In 1995 a Department of Health committee comprising representatives from my Department, consultant microbiologists, specialists in public health medicine, general practice and a representative from the Association of Infection Control Nurses produced a set of guidelines for the management of MRSA in acute hospital wards, including specialist units. The implementation and operation of these guidelines in acute hospitals is a matter for the hospitals in question in the first instance. The guidelines have been widely circulated and include an information leaflet for patients.
The infection control sub-committee of the national SARI committee recently prepared draft guidelines on the control of MRSA in hospitals and community health care settings. The key recommendations cover such areas as environmental cleanliness, bed occupancy levels, isolation facilities, hand hygiene, appropriate antibiotic use and protocols for the screening and detection of MRSA. These draft guidelines, based on the best evidence available internationally, are a key component in the response to MRSA. The recommendations, when signed off by the national hospitals office of the HSE, will replace the guidelines issued in 1995 on MRSA.
Effective infection control measures, including environmental cleanliness and hand hygiene, are central to the control of hospital acquired infections, HAIs, including drug resistant organisms such as MRSA. The HSE and hospital managers have corporate responsibility for infection control. Infection control, including hand hygiene, is a key component in the control of MRSA. The SARI infection control sub-committee released national guidelines for hand hygiene in health care settings during 2004. These have been widely circulated by the HPSC and are available on its website, www.hspc.ie.
The ten point plan for accident and emergency departments which I announced in November 2004 includes provision for dedicated cleaning services and recognises the importance of hospital cleanliness. The national hospitals office of the HSE has identified the auditing and targeting of infection control initiatives and the enhancement of cleanliness of hospitals as priorities in its service plan for 2005.
