Willie Penrose (Westmeath, Labour)
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Question 88: To ask the Minister for Health and Children the most up to date figures on MRSA and deaths attributed to MRSA; her views on the setting up of a national directorate for the inspection, prevention and control of MRSA and other hospital acquired infections such as C difficile; when the Health Service Executive will publish an action plan in this area; and if she will make a statement on the matter. [41463/06]

Bernard Durkan (Kildare North, Fine Gael)
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Question 146: To ask the Minister for Health and Children the action she has taken or proposes to take to address the issue of the ever increasing risk from MRSA in the various hospitals here; if incidents to date have related to hospitals only, public hospitals only, or health centres; the cost and effectiveness of the preventative measures she has taken to date; and if she will make a statement on the matter. [41373/06]

Bernard Durkan (Kildare North, Fine Gael)
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Question 329: To ask the Minister for Health and Children the number of patients to date deemed to have contracted MRSA or similar infections while in public or private hospitals; the action taken to date or proposed to deal with the issue; and if she will make a statement on the matter. [41692/06]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 88, 146 and 329 together.

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). EARSS collects data on the first episode of blood stream infection per patient per quarter. The Irish data for EARSS, which is published on a quarterly basis by the HPSC, showed that there were 445 cases in 2002, 480 cases in 2003, 553 cases in 2004, 586 cases in 2005 and 285 reported cases in the first half of 2006. It is difficult to identify the number of fatalities attributable to MRSA as many people also have significant co-morbidity factors.

Clostridium difficile is not a notifiable disease and as a result it is difficult to quantify the extent of infection in the health care system. However, Clostridium difficile infection was examined in The Third Prevalence Survey of Health Care Associated Infections (HCAIs) in acute hospitals in 2006. The survey found that thirty-six patients had Clostridium difficile representing 0.5% of patients studied. Clostridium difficile infection increases with age and is eight times more common in patients over 65 years compared to those under the age of 65 years. The emergence of more virulent strains of Clostridium difficile which is partly due to over use of antibiotics underlines the importance of strict antibiotic stewardship in our health care system.

This year, Ireland participated in the Hospital Infection Society's "Prevalence Survey of Health Care Associated Infections" (HCAIs) in the United Kingdom and Ireland. The survey, which included 45 Irish acute adult hospitals, including 8 private hospitals, provides accurate and comparable data on the prevalence of Health Care Associated Infections (including MRSA) and can also be compared with similar data being obtained in England, Scotland, Wales and Northern Ireland. Preliminary results of this study are now available. The overall prevalence of health-care associated infection in the UK and Ireland study (these figures exclude Scotland) is 7.9%. The England figure is 8.2%, Wales 6.3%, Northern Ireland 5.5% and the Republic of Ireland 4.9%. The prevalence of health-care associated infection was highest in regional/tertiary hospitals at 6% and lowest in specialist hospitals at 2%. There is no room for complacency and HSE must continue to work with hospitals to control HCAIs.

Community acquired MRSA infections are generally caused by strains of MRSA bacteria that differ to strains associated with hospitals. The Irish National MRSA Reference Library carried out a preliminary study in 2005 to look for evidence of such community acquired strains of MRSA in Ireland. They identified five patients with such strains, four of which appear to have acquired the infection outside Ireland.

Measures to control the emergence and spread of HCAIs are necessary because there are fewer options available for the treatment of resistant infections and because these strains spread amongst vulnerable at-risk patients. The prudent use of antibiotics underpins any approach to the control of antibiotic resistant bacteria, including MRSA. This, together with good professional practice and routine infection control precautions, such as hand hygiene, constitute the major measures in controlling and preventing healthcare-associated infection, including that caused by MRSA, both in hospital and in community health care units. While many HCAI are not preventable, we can make every effort to reduce the rates of infection and to treat them promptly when they occur.

A Strategy for the control of Antimicrobial Resistance in Ireland (SARI) was launched in 2001 and includes recommendations such as hospital hygiene practise, appropriate antibiotic prescribing, active surveillance for the detection of MRSA and corporate/ clinical governance structures in the area of infection control.

The base funding for MRSA and HCAI is €4.5m. The funds allocated to SARI since its launch are:

2001: €2,539,000

2002: €4,383,000

2003: €4,492,000

Funding for 2004 and 2005 has remained the same, with an increase in each year to allow for inflation.

The HSE has appointed Dr. Kevin Kelleher, Assistant National Director of Health Protection, as the lead person nationally, for MRSA in the HSE. He is supported by senior representatives of the NHO, PCCC and Risk Management as well as senior clinicians. The HSE are shortly to publish a three year Action Plan which will set targets for the control and management of HCAIs.