Pat Rabbitte (Dublin South West, Labour)
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Question 64: To ask the Minister for Health and Children the information available to her on the incidence of MRSA, C Difficile and other infections in hospitals here; the measures being taken to reduce the spread of these infections; and if she will make a statement on the matter. [2712/08]

Bernard Durkan (Kildare North, Fine Gael)
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Question 138: To ask the Minister for Health and Children the extent to which hospitals in both the private and public sector have been affected by MRSA; the action taken to address this issue; and if she will make a statement on the matter. [2971/08]

Bernard Durkan (Kildare North, Fine Gael)
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Question 139: To ask the Minister for Health and Children the extent to which MRSA is under control; the number of patients who contacted the disease in the pact 12 months; the action taken in response; and if she will make a statement on the matter. [2972/08]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 64, 138 and 139 together.

I would like to assure the Deputies that tackling Health Care Associated Infections (HCAIs), including MRSA and C Difficile, continues to be a priority for the government and for the Health Service Executive (HSE). It should be noted that the HSE does not have a remit in relation to private hospitals.

The European Antimicrobial Resistance Surveillance System (EARSS) was established in 1999 in response to the growing threat of antimicrobial resistance in Europe. In 2007, 43 Irish laboratories serving 64 acute hospitals (public and private) participated in EARSS representing an estimated 98% coverage of the Irish population. In 2007, by the end of the 3rd Quarter (the most up to date figures available) there were 1,035 isolates of Staphylococcus Aureus blood stream infection of which 432 (41.7%) were MRSA. The annual trends indicate that the proportion of MRSA in Ireland has levelled off at approximately 42% since 2002.

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.

The extent to which hospitals are affected by MRSA varies with the type of hospital. In the 2006 prevalence survey of healthcare associated infections, the prevalence of MRSA was 0.5% in tertiary/regional and general hospitals, and was zero in specialist hospitals.

A National Surveillance System has recently been established by the HSE to collect data and provide information on a quarterly basis on four key areas, to monitor HCAIs in our healthcare system:

1. Staphylococcus bacteraemia;

2. Antibiotic consumption;

3. Alcohol gel use;

4. MRSA surveillance in Intensive Care Units.

A report on the 2006 data from the system is expected to be made available by the Surveillance Centre in the near future and work has commenced on providing information in respect of 2007. All of this will greatly assist in the monitoring of improvements in infection control.

The HSE launched a National Infection Control Action Plan in March 2007. An Infection Control Steering Group, chaired by Dr. Pat Doorley, National Director (Population Health) is responsible for overseeing the implementation of the plan. Over the next three to five years, the HSE aims to reduce HCAIs by 20%, MRSA infections by 30% and antibiotic consumption by 20%. Achievement of these targets will benefit all patients who are at risk. These targets will be achieved through the development of national and local level action plans to reduce the potential for spread of infections between persons in healthcare settings and, in addition, will focus on reducing antibiotic use in Ireland. The Steering Group is supported by eight Local Implementation Teams which will ensure that all local facilities are focused on achieving the national targets.

The Health Information and Quality Authority (HIQA) undertook a comprehensive review of hygiene in our hospitals in 2007 against hygiene standards developed by the Irish Health Services Accreditation Board. HIQA published its report, the National Hygiene Services Quality Review, on 13th November, 2007. The report represents a thorough assessment of how hygiene services are provided and managed in 51 HSE-funded acute care hospitals. Hospitals generally performed well on hygiene in the service delivery area. Most hospitals achieved either extensive or exceptional compliance with the standard in the service delivery section of the report. However, the results were poor on governance. While the good hygiene practice of front line staff highlighted in the report is vital, real improvement in this whole area also depends heavily on good leadership and a system of governance. HIQA is currently working with managers and clinicians to develop national standards for Infection Prevention and Control. When completed these, along with the national hygiene standards, will provide a comprehensive framework to help reduce the spread of infection and improve the quality of our health care.

The availability of isolation facilities is an important factor in the overall solution to the issue of reducing incidence of infection. I have instructed the HSE that designated private beds should be used where isolation facilities are required for patients who contract MRSA and this policy has been adopted by the HSE. New environmental building guidelines are being prepared by the HSE to inform infection control policy in all new builds and refurbishments and the HSE is committed to ensuring that such facilities are in line with best international practice including the provision of adequate numbers of single units.

While accepting that not all HCAIs are preventable, I am satisfied that significant steps are being taken to reduce the rates of infections and to treat them promptly when they occur.