Surveillance of Healthcare Associated Infections Report 2007
Best practice, Review, Surveillance data
This is the second report on HCAI, which focuses on those infections subject to mandatory surveillance. However, it places them in the context of broader surveillance, not currently mandatory, of bloodstream infections and surgical site infection. This gives a broader perspective and sometimes additional information which then inform the findings from the mandatory surveillance. This report covers general trends in bloodstream infections, with an emphasis on changes in recent years and the infections subject to mandatory surveillance, MRSA and glycopeptide-resistant enterococcal bacteraemia; C. difficile infection; and surgical site infection. As mandatory surveillance of HCAIs started at different times, this report deals with different periods, covering the latest year of the mandatory surveillance and comparing this with previous years. Thus we report on the sixth year of S. aureus bacteraemia surveillance and the third years of glycopeptide-resistant enterococcal bacteraemia, C. difficile infection and orthopaedic surgical site infection. Some of the data will have been published before for the separate surveillance systems, on completion of the relevant surveillance year, as the frequency of reporting of the results varies: quarterly for S. aureus bacteraemia and C. difficile infection, annually for orthopaedic surgical site infection and glycopeptide-resistant enterococcal bacteraemia. As with all surveillance, the caveats are important and affect interpretation of the data. Direct Trust comparisons are tempting, but there may be differences between Trusts in the types of patients treated and the spectrum of clinical activity which mean that they are not directly comparable. Consequently caution should be exercised in interpreting the results and outlying rates should be subject to further investigation to assess whether they reflect differences in case-mix or actual performance.