Figures released by the Health Protection Agency show that MRSA cases have fallen and C.Diff cases are still increasing, albeit at a lesser rate.
Dr Andrew Berrington, Consultant Microbiologist, Sunderland Royal Hospital, said:
“The reduction in MRSA isolation from blood cultures is welcome but needs to be interpreted carefully. The numbers are not all genuine cases of MRSA ‘blood poisoning’ but include a significant minority of false-positives resulting from skin contamination. When you give trusts targets they will find creative ways to meet them, and it’s possible that some or all of the reduction is because of efforts to reduce contamination. Journalists should also be aware that MRSA bacteraemia is the tip of the iceberg of MRSA infection, most of which is not counted in any systematic way. Anyway the hope of halving MRSA bacteraemia rates by 2008 is not going to be realised, probably because fewer than half of cases are preventable.
“The rise in C. difficile numbers in the over 65s is of concern but again should be interpreted in context. Remember that these are laboratory figures – they will miss cases diagnosed in other ways (some patients are diagnosed by sigmoidoscopy) and they will include cases that don’t meet the clinical definition of C. difficile disease (including patients whose diarrhoea is caused by something else). Some of the rise might be increased ascertainment because of delayed recognition of the requirement to test all diarrhoeal specimens. Nevertheless it is very concerning, and might reflect the advent of newer and more pathogenic strains of the bacterium. Trusts must continue to make every effort to control this infection.”
Richard James, Professor Of Microbiology, Nottingham University, said:
“The reduction is welcome but there is a long way to go to further reduce preventable infections.
Contamination of the hospital environment with C.difficile spores requires more than a bucket and mop to remove them. High bed occupancy rates are not compatible with the control of C. difficile infections.”