Bernard Durkan (Kildare North, Fine Gael)
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705. To ask the Minister for Health the extent to which MRSA or other hospital bugs have been contained in recent times; and if he will make a statement on the matter. [27176/16]

Simon Harris (Wicklow, Fine Gael)
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The prevention and control of healthcare associated infections (HCAIs) and Antimicrobial Resistance (AMR) continues to be a significant, long-standing patient safety and public health priority for the Department of Health. A wide range of initiatives has been put in place in the Irish health system over several years in response to the rising incidence of AMRs and subsequent risk of contracting a HCAI. These include:

- improved surveillance of infections and prescribing;

- infection prevention and control processes;

- antimicrobial stewardship initiatives;

- public and professional awareness raising, with a significant emphasis on the education and training of healthcare professionals;

- A current review and update of National Clinical Effectiveness Committee (NCEC) national Guidelines on MRSA (2013) and Clostridium difficile (2014) for healthcare professionals;

- a current review and update of HIQA's National Standards for the Prevention and Control of Healthcare Associated Infections (HCAIs) (2009).

In Ireland AMR in key clinically important bacteria known to cause potentially serious infections, such as bloodstream infection, (BSI) has been systematically monitored over the past decade by Irish microbiology laboratories serving all acute hospitals. There has been almost complete reporting of AMR data on BSI to the Health Service Executive's Health Protection Surveillance Centre (HPSC) where data is analysed and reported back directly to participating laboratories and hospitals on a quarterly basis.

The HPSC also published reports on the latest available national BSI AMR surveillance data and hospital level AMR surveillance data on its website at: and .

There has been a marked decrease in the rates of MRSA reported for Irish acute hospitals since 2007, both in the number of cases and as a percentage of overall bloodstream infections reported (which have also decreased):

- In 2007 the HPSC reported 536 cases of MRSA infection from a total of 1,393 overall 'isolates', representing 38.5% of cases;

- In 2015 the HPSC reported 199 cases of MRSA infection from a total of 1,082 overall isolates, representing 18.4% of cases.

- Provisional HPSC data for 2016 (Quarter 1 only) shows the downward trend in cases of MRSA infection continuing, with a small increase in overall bloodstream infection rates. However, the HPSC cautions that provisional data is subject to change and it cannot be assumed that quarterly data yet to be reported will mirror data as reported in previous quarters.

On foot of concerns about outbreaks of Multi-Drug resistant Organisms (MDROs) in recent years a National Taskforce on AMR to address the issues of managing and reducing AMR and HCAI was established by the HSE in 2015. The Taskforce's remit is to direct and coordinate an effective system-wide response to the issue of HCAI/AMR.

The Taskforce is a multi-disciplinary high-level group that supports and advises HSE Divisions on reducing incidences of MDRO through ensuring rational antimicrobial use across all healthcare settings, providing effective diagnostic support for infection, improving professional education, training and public engagement to promote wider understanding of the need for appropriate use of antibiotics, ensuring compliance with the National Standards for the Prevention and Control of HCAI across all healthcare settings and ensuring implementation of national guidelines across all healthcare settings.

Ireland also fully supports the World Health Organisation (WHO) Global Action Plan on Antimicrobial Resistance (2015) and recent Council Conclusions on AMR (June 2016). The Council calls on Member States to have in place before mid-2017 'a national action plan against Antimicrobial resistance based on the 'One Health' approach and in line with the objectives of the WHO Global Action Plan'. (The 'One Health ' concept is a worldwide strategy for expanding interdisciplinary collaborations and communications in all aspects of health care for humans, animals and the environment). The WHO is working with countries to support the development and implementation of their national plans, and will report progress to the World Health Assembly in 2017.

Through the Interdepartmental AMR Consultative Committee, established and co-chaired by the Chief Medical Officer of this Department and the Chief Veterinary Officer of the Department of Agriculture, Food and the Marine and endorsed by both respective Ministers, Ireland is addressing the Council's requirement for all Member States to have in place an Intersectoral co-ordination Mechanism to develop a national action plan against AMR to encompass both the human and animal sectors, agriculture and the wider environment. The Committee was launched on European Antibiotic Awareness Day in November 2014 and has a clear role and mandate across the human and animal health sectors. Committee membership consists of representatives of both Departments and of the relevant HSE and veterinary specialist agencies, including other relevant bodies with a remit across the two sectors; membership is representative of major stakeholders. The Committee meets bi-annually and its most recent meeting took place on 13 April 2016.

A key action for the Committee's work during 2016 is the development of Ireland's AMR national action plan. This plan will cover the use of antimicrobial medicines in animal health and agriculture, as well as for human health. This work is continuing and the Committee is scheduled to meet again in late 2016 to assess progress on this major agenda item.

The prevention and control of healthcare associated infections (HCAIs) and AMR has been a significant patient safety and public health priority for the Department of Health Ireland for numerous years. Ireland as a whole is fully committed to and engaged in addressing resolution of the problem of AMR and will continue to collaborate at international, EU and national levels to this end.