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Enhanced surveillance of MRSA bacteraemia in English hospitals: comparison of risk factors in patients with community onset bacteraemia with cases whose onset was in hospital

Abstract number: 1733_815

Pearson A., Wagner K., Murray M., Painter M., Giltrow J., Fleming M.

Objective: The English Department of Health introduced mandatory reporting of methicillin resistant (MRSA) and sensitive (MSSA) Staphylococcus aureus bacteraemia in April 2001. In 2004 a performance target for a 50% reduction in the numbers of MRSA bacteraemia was set for April 2008. Enhanced mandatory MRSA bacteraemia surveillance was introduced in October 2005. This paper compares the patient characteristics of admission diagnosed cases of MRSA bacteraemia with hospitalised MRSA bacteraemia cases in acute NHS hospitals in England.

Methods: The analysis presented was based on information sent to a web enabled database as part of a national mandatory surveillance scheme between October 2005 and September 2006. Standardised screen formats were used to record the mandatory enhanced surveillance data. From May 2006 an optional data collection screen became available on the system which enabled entry of additional data on source, risk factors and prior healthcare contacts for each MRSA bacteraemia case.

Results: During October 2005 to September 2006 approximately 7,000 reports of MRSA bacteraemia were received from 172 English Trusts. Early enhanced surveillance data collected on a voluntary basis suggest that the most common source of MRSA bacteraemia in patients with community onset bacteraemia was skin/soft tissue infection (23%), followed by UTI (17%). In contrast the most common source of MRSA bacteraemia in patients who had been admitted for 2 or more days before their bacteraemia was detected was CVC associated (23%), followed by PVC associated (20%). The most common risk factors for both groups were peripheral IV devices, followed by central IV devices.

Conclusion: Data from the MRSA bacteraemia enhanced surveillance scheme provide an important means of identifying risk factors and sources of bacteraemia in English patients. Skin/soft tissue infections (the most common source of bacteraemia in the admission diagnosed group) may result from the use of peripheral IV devices, the most common risk factor in this group. It is hypothesised that a large proportion of those patients presenting to the acute trust hospital with an MRSA bacteraemia developed this condition as a result of a prior healthcare contact. Identification of key risk factors and sources of bacteraemia will allow effective targeting of infection control interventions.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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