Healthcare associated infections

Clostridium difficile infection (C difficile) and methicillin-resistant staphylococcus aureus (MRSA) are bacterial infections which commonly affect people in hospitals and nursing homes. These have become a marker for healthcare acquired infections.

How has the frequency of reported Clostridium difficile infections changed?

In 2007 the levels of hospital associated infections, which includes C difficile, became a major national concern in particular following the Healthcare Commission’s investigation into Maidstone & Tonbridge Wells NHS Trust (Healthcare Commission 2007). Action to address these problems was far reaching and included new legislation as well as focussed investment, regulation and performance monitoring against targets. Since this focus in 2007 the number of C difficile infections decreased year-on-year for all groups to a low in 2013/14. In 2014/15 there was a slight increase from the previous year in C difficile infections, a 6.0% increase for all cases of 2 years and over and a 3.6% increase for trust apportioned cases (meaning the bacteraemia was likely to have been acquired while patients were in their care) in those 2 years and over. *annual data for 65 and over only available up to 2010/11.

Source: 
Health Protection Agency, Mandatory surveillance of bacteraemia

How has the frequency of MRSA infections changed?

In 2007, the level of hospital acquired MRSA infections also became a major national concern, similar to C difficile. The reduction in the number of MRSA cases has followed a similar trajectory to that of C Difficile, however, this trend continued in 2014/15. An 82% reduction in all reported cases between 2007 and 2015, and an 82% reduction in trust apportioned cases between 2008 and 2015.

Source: 
Health Protection Agency, Mandatory surveillance of bacteraemia
About this data

'Total’ refers to all toxin positive results for C difficile that are detected by the trust whose laboratory processes the specimen. It is important to note that this does not necessarily imply that the infection was acquired there.

'Trust apportioned’ refers to C difficile infections that are likely to be an infection acquired at the  trust I (for patients aged 2 years and over) if the following rules are met: the location where the specimen was taken is given as 'acute trust' or is not known; the patient was either an 'in-patient', 'day-patient', in 'emergency assessment' or is not known; patient's specimen date is on, or after, the fourth day after admission (or admission date is null), where the day of admission is day 1.

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