Dáil Éireann Debate, Wednesday - 18 December 2013
258. Deputy Bernard J. Durkan asked the Minister for Health the extent to which steps have been taken to eliminate MRSA or other such infections throughout the hospital service; and if he will make a statement on the matter. [54693/13]
Amharc ar fhreagraThe 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%). I was pleased last week to launch and endorse 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 a halving of MRSA since 2006, 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. This National Guideline is a significant pro-active step in this direction and I would like to acknowledge the work of the Clinical Advisory Group on healthcare associated infections - MRSA Guideline Committee of the Royal College of Physicians Ireland in developing this guideline.
