Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Question 306: To ask the Minister for Health and Children if she has been in contact with the Health Minister in the Six Counties in relation to joint approaches to hospital-based infections such as MRSA and clostridium difficile; and if she will make a statement on the matter. [6748/08]

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Question 307: To ask the Minister for Health and Children if her attention has been drawn to the alarm caused at the large number of deaths attributed to clostridium difficile in hospitals in all of the Health Trust areas in the Six Counties; the known incidence of the disease in this jurisdiction; if there are figures for the level of infection by hospital and by Health Service Executive region; if there are figures for the incidence of C-Diff and MRSA in private hospitals; and if she will make a statement on the matter. [6749/08]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 306 and 307 together.

There is ongoing North/South co-operation in relation to many health issues. I met with Minister McGimpsey, Minister for Health, Social Services and Public Safety, Northern Ireland in October and November 2007. The specific issue of MRSA/hospital associated infections was not discussed on those particular occasions. However, since the early part of this decade our National SARI Group has worked jointly with the Anti-Microbial Resistance Action Plan Group in Northern Ireland which is part of their Department of Health, Social Services and Public Safety. The HSE has also collaborated with Northern Ireland and the UK in a recent prevalence study on HCAIs and will continue to work together like this, where feasible, into the future.

Health Care Associated Infections (HCAIs) are not new and are a challenge for all healthcare providers in all jurisdictions. For centuries they have been a side effect of medical treatment, especially in hospitals. There are a number of types of HCAI, MRSA and Clostridium difficile are two such types. The more medical care a person requires, the more likely they are to develop a health care associated infection. These infections are, therefore, more common among people with serious illnesses or at high risk such as patients with a weakened immune system, patients who have been treated for leukaemia or cancer, or who have had an organ transplant.

In Ireland, the Health Protection Surveillance Centre of the HSE has been collecting data on MRSA for some time now. In 2007, 43 Irish laboratories serving 64 acute hospitals (public and private) participated in their data collection system representing an estimated 98% coverage of the Irish population. At present we do not have the relevant statistics for each individual hospital. However the total number of MRSA cases recorded over the last five years was 445 cases in 2002, 480 cases in 2003, 553 cases in 2004, 592 cases in 2005, 588 cases in 2006 and 432 cases by the end of the 3rd Quarter in 2007.

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 health system: Staphylococcus bacteraemia; Antibiotic consumption; Alcohol gel use; MRSA surveillance in Intensive Care Units.

The data for 2006 is currently being finalised and a report will be released by the Health Protection Surveillance Centre in the near future. This report will include rates of MRSA bloodstream infection, listed by individual hospital. Data for 2007 will be available in early 2008 and MRSA bloodstream infection rates for all publicly funded hospitals will be published quarterly thereafter. All of this will greatly assist in the monitoring of improvements in infection control.

Clostridium difficile is not at present 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 in acute hospitals in 2006. The survey found that thirty-six patients had Clostridium difficile representing 0.5% of patients studied. My Department, in conjunction with the HSE, is actively considering the addition of a small number of diseases including Clostridium Difficile to the list of notifiable diseases. This will be finalised as soon as the EU issues a new list of case definitions. In the meantime I am arranging that Clostridium Difficile be included as an organism which is notifiable under the category acute infectious gastroenteritis. This will in effect make Clostridium Difficile notifiable in the short term.

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.

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