MRSA & Clostridium difficile trends


This information is written for patients, carers or anyone who is interested in trends in MRSA bloodstream infections or Clostridium difficile. It also aims to provide an overview of the impact of post-infection review following the contraction of an MRSA bloodstream infection whilst receiving healthcare.

Zero tolerance and post-infection review

The purpose of post-infection review is to identify how a case occurred and to identify actions that will prevent it reoccurring. From April 2018 the post-infection review process changed and is only required for organisations who have higher numbers of MRSA bloodstream infections or Clostridium difficile or where a healthcare provider wishes to demonstrate how they will improve standards of care.

Post-infection review relies on strong partnership working by all organisations involved in the patient's care, to jointly identify and agree the possible causes, or factors that contributed to the patient's MRSA bloodstream infection, and is also used where Clostridium difficile is more prevalent. Guidance has been produced to aid in the identification, information exchange and reporting of cases of MRSA bloodstream infection to help Clinical Commissioning Groups (CCGs) and healthcare providers conduct post infection reviews. It is considered unacceptable for a patient to acquire an MRSA bloodstream infection while receiving care in a healthcare setting. It has set healthcare providers the challenge of demonstrating zero tolerance to MRSA bloodstream infections through a combination of good hygienic practice, appropriate use of antibiotics, improved techniques in the care and use of medical devices, and adherence to best practice guidance.

Healthcare providers are expected to ensure that MRSA bloodstream infections become exceptional events, or events that could not have been prevented whilst receiving healthcare. The hospital trust hosting the laboratory that processes samples will usually undertake the data entry. The integrity of the data entry will be assessed during the post infection review.

Monthly data is published by hospital trust and clinical commissioning group. Statistics are published using the revised Public Health England regional areas.

Clinical definitions of Clostridium difficile infection can be found in the Department of Health publication Clostridium difficile - How to Deal with the problem, December 2008

Public Health England has made information available on mandatory reporting and antimicrobial resistance in the health profile portal, which is accessible to the public. To find out how your area is performing visit Public Health England’s Antimicrobial Resistance pages.

Latest numbers of MRSA and Clostridium difficile (external website):

Health Protection Agency Weekly reports of MRSA and Clostridium difficile infection (CDI)

Staphylococcus aureus: guidance, data and analysis from Public Health England

Clostridium difficile: guidance, data and analysis from Public Health England

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