Written answers

Wednesday, 31 January 2007

Department of Health and Children

Infectious Diseases

8:00 am

Photo of Richard BrutonRichard Bruton (Dublin North Central, Fine Gael)
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Question 709: To ask the Minister for Health and Children the number of cases detected of hospital acquired infections, distinguishing the type of infection (details supplied) in each hospital across the country. [1444/07]

Photo of Mary HarneyMary Harney (Dublin Mid West, Progressive Democrats)
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Most acute hospitals collect information on health care associated infections (HCAIs) in their institution at a local level. Currently there is no national surveillance scheme that collects comparable data on health care associated infections at a national level. However, the appointment of the SARI infection control nurses, surveillance scientists and antibiotic pharmacists who are due to be recruited in early 2007 will provide extra staffing required to commence a national surveillance programme. Once these staff are in place, national surveillance of HCAIs will commence, in line with SARI recommendations and international best practice.

However, the Health Protection Surveillance Centre (HPSC) collects data on MRSA bacteraemia 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 435 reported cases in the first three quarters of 2006.

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. In 2006 the Hospital Infection Society (HIS) UK carried out its Third Prevalence Survey of Health Care Associated Infections in acute hospitals. The survey covered Ireland, England, Scotland and Wales between March and May 2006, and the preliminary results have been published. 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%. Clostridium difficile infection was examined in this survey and it was found that thirty-six patient had clostridium difficile representing 0.85% 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.

Infection due to norovirus (also known as NLV, Small Rounded Structured Virus (SRSV) or "Winter Vomiting Disease") is extremely common within the community and the outbreaks in health care settings are simply a reflection of what is happening in the community. Outbreaks due to the norovirus are not eradicable but they are controllable and having an agreed hospital/residential home outbreak plan in place is the best method for ensuring uniformity and effectiveness of response. Norovirus infection was also examined in the Third Prevalence Survey of Health Care Associated Infection (HCAIs) in acute hospitals in 2006. The survey found that seven patients had norovirus infection representing 0.4% of patients studied.

The results for the HIS prevalence survey are currently being validated in the UK and once this is completed a final report on the Irish results will be published.

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