Bernard Durkan (Kildare North, Fine Gael)
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Question 185: To ask the Tánaiste and Minister for Health and Children the number of hospitals in respect of which there have been reports of incidences of MRSA in each of the past three years; the extent to which an investigation took place into the cause in each case; and the subsequent action taken; and if she will make a statement on the matter. [14257/05]

Bernard Durkan (Kildare North, Fine Gael)
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Question 186: To ask the Tánaiste and Minister for Health and Children the number of cases of MRSA reported in each of the past three years; the degree to which this infection is on the increase; the action taken to address the issue; and if she will make a statement on the matter. [14258/05]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 185 and 186 together.

The Health Act 2004 provided for the Health Service Executive, which was established on 1 January 2005. Under the Act, the executive has the responsibility to manage and deliver or arrange to be delivered on its behalf health and personal social services. This includes responsibility for infection control including the control of MRSA. Accordingly, my Department has requested the director of the National Hospitals Office to investigate the matters raised regarding the number of hospitals in respect of which there have been reports of incidences of MRSA in each of the past three years, the extent to which an investigation took place into the cause in each case and the subsequent action taken and to reply direct to the Deputy in this regard.

MRSA, methicillin resistant staphylococcus aureus, is a resistant form of staphylococcus aureus. The health protection surveillance centre, HPSC, collects data on MRSA bacteraemia, also known as bloodstream infection or "blood poisoning", as part of the European antimicrobial resistance surveillance system, EARSS. In 2002, 445 cases of MRSA bacteraemia were notified to the HPSC while 477 cases were notified in 2003. Provisional figures for 2004 indicate that 533 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 just reflect the increased number of participating laboratories.

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 those hospitals in the first instance. These 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 in Ireland. The recommendations, when signed off by the National Hospitals Office of the HSE, will replace guidelines issued by this Department in 1995 on MRSA.

At national level, MRSA bacteraemia has been included since 1 January 2004 in the revised list of notifiable diseases under the infectious diseases regulations. As such laboratories are now legally required to report cases of serious MRSA infection to the departments of public health and the HPSC. 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. As MRSA bacteraemia is a laboratory diagnosed disease, notification is done per clinical laboratory rather than on a hospital by hospital basis.

Effective infection control measures, including environmental cleanliness and hand hygiene, are central to the control of hospital acquired infections, 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, which have been widely circulated by the HPSC and are available on the HPSC's website, www.hspc.ie. The ten point plan for accident and emergency 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 Health Service Executive 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.