Survey shows improvements in hospital acquired infections

The Public Health Agency (PHA) is today publishing the results of the 2012 Point Prevalence Survey (PPS) of hospital-acquired Infections (HAI) and antimicrobial use (AMU) in Northern Ireland. The survey helps to determine the overall burden of HAI and AMU in our acute hospitals and also helps to inform the priority areas for future working.

PPS 2012 included 3,992 in-patients across 16 acute and local hospitals. The results indicate that the prevalence of HAI (i.e. number of patients with a hospital-acquired infection present in an acute hospital at a given point in time) is lower than previously described in Northern Ireland.

Overall only 4.2% of patients surveyed had an HAI. HAI prevalence is lower by around one fifth than that reported in the previous survey which was completed in 2006. This finding compares positively to results recently published throughout the rest of the UK.

The most common types of HAI identified in PPS 2012 were respiratory (27.9 %), surgical site (18.9 %) and urinary tract (11.8 %). A considerably lower prevalence of gastrointestinal infection was recorded in 2012 than in 2006 - and in particular Clostridium difficile infections were found to be much lower. Since the last survey there has been a reduction in MRSA infections - from 0.9 % to less than 0.1 % of patients surveyed.

PPS 2012 is the first survey to look at both HAI and also AMU. Overall, the number of patients receiving one or more antibiotics in an acute hospital setting at the time of the survey (described as AMU prevalence) was 29.5%. This finding compares positively to the European average and to results recently published throughout the rest of the UK.

A total of 434 patients out of 3,992 (10.9%) were receiving more than one antibiotic and AMU was highest in adult intensive care units – 55.6% (55 patients).

The most common reason for antibiotic treatment was for a community acquired infection (60.1%) followed by a hospital-acquired infection 18.3%. A total of 1,142 antimicrobials (65.2%) were delivered intra-venously. Overall 7% and 6.6% of antimicrobials prescribed were for prevention of infection following surgical and medical treatment.

Deputy Chief Medical Officer, Dr Elizabeth Mitchell said: “I welcome the completion of this survey and the publication of the report. I would like to acknowledge the contribution of all the Public Health Agency and Trust staff involved.

“The report shows that Northern Ireland compares well with other parts of the UK and that we have made good progress since 2006 in the prevalence of hospital-acquired infections. However we must not be complacent: we need to keep on improving. This survey gives us robust evidence that will be used to support infection prevention and control improvement across all hospitals in Northern Ireland.”

Dr Lourda Geoghegan, Consultant in Health Protection, PHA, said: “I am very pleased today to report the initial findings of PPS 2012. This is an important survey and I would like to sincerely thank everyone who contributed to making the survey a success. Trust and PHA staff worked very effectively together to ensure our PPS was robustly and efficiently completed.

“The survey provides very important information for us, highlighting the successes we have achieved to date in reducing and preventing HAI, and also identifying areas for further work going forward. The survey demonstrates the impact of our recent programmes targeting Clostridium difficile and MRSA infections across our hospitals, with considerable reductions reported in both infections.

“PPS 2012 also provides us with a comprehensive summary of the position regarding antibiotic use in our hospitals. While the overall proportion of patients receiving antibiotics was encouraging, we cannot be complacent in this regard. Antibiotic overuse is a serious problem and a threat to everyone’s health. We will use findings from the survey to further enhance antibiotic stewardship across our services.”

Dr Anne Kilgallen, Medical Director, Western Health and Social Care Trust said: “This report contains good news for our population in terms of the reduction in prevalence of hospital acquired infections seen between the two surveys. As a Trust, the report is useful because it gives us further information on which to base our approach to protecting patients from such infections. It contains a wide range of information on the use of antimicrobials and this helps us at ward level to focus our efforts on appropriate use.”

The full report can be downloaded here