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Phoebe Martin

Hospital Acquired Infections a Look into MRSA Infections and the Occurrence of MRSA Bacteraemia in Different Regions of England. Phoebe Martin. What are Hospital Acquired Infections?. ‘ Infections acquired in hospital by a patient who was admitted for a reason other than that infection’

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Phoebe Martin

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  1. Hospital Acquired Infectionsa Look into MRSA Infections and the Occurrence of MRSA Bacteraemia in Different Regions of England. Phoebe Martin

  2. What are Hospital Acquired Infections? • ‘Infections acquired in hospital by a patient who was admitted for a reason other than that infection’ • Fungal, bacterial, viral or parasitic organisms • Most common complication and a main cause of preventable injury and death http://1.bp.blogspot.com/_PB5-El7se4s/Rw3tj-QWGJI/AAAAAAAAEO8/ZrdNoPn9TmI/s400/mrsacart.jpg http://www.life.umd.edu/classroom/bsci424/Images/PathogenImages/FourQuadrantStreakPlate.jpg

  3. Prevalence of HAIs in Hospitals Worldwide - 1/20 of all healthcare patients in the USA - 2002 – 1.7 million patients acquired HAIs, resulting in approximately 99,000 deaths - Annual national healthcare costs increase by $4.5 billion - Acquisition most common in ICU – 30% of all ICU patients acquire an HAI - In Europe: Switzerland – 11.6% The Netherlands – 6.9% http://1.bp.blogspot.com/-F8daOPNBUT4/T2PEGH_pEUI/AAAAAAAAAEo/SN5bGFe2m1w/s1600/hospital_ward__beds.jpg

  4. Prevalence of HAIs in the UK - Rates vary within the UK - HIS reported 8.2% rate in English hospitals • - The most common types of infection in England are GIs • (22%) and UTIs (19.7%)

  5. Most Prevalent Causative Pathogens • Escherichia coli • Streptococcus pneumoniae • Influenza virus A • Staphylococcus aureus • Clostridium difficile • Norovirus • Pseudomonas aeruginosa http://upload.wikimedia.org/wikipedia/commons/2/2d/Escherichia_coli.jpg https://upload.wikimedia.org/wikipedia/commons/2/20/Streptococcus_pneumoniae.jpg http://upload.wikimedia.org/wikipedia/commons/2/2d/Pseudomonas_aeruginosa_Gram.jpg

  6. Methods of Prevention • ‘Modern Matrons’ (2000) • ‘The Deep Clean’ (2007-2008) • ‘The Healthcare Associated Infections Technology Programme including the Rapid Review Panel’ (2008) http://blog.al.com/montgomery/2012/04/6_teenagers_hospitalized_after.html • ‘MRSA screening‘ (2009) - ‘Cleanyourhands campaign’ (ongoing) http://www.microphage.com/product/screeningMrsaUS.cfm

  7. Methicillin Resistant Staphylococcus aureus - MRSA • Non-motile, aerobic, gram-positive cocci • 30% of people are asymptomatic carriers • Infection occurs upon microorganism entering the blood stream http://www.mrsaresources.com/

  8. Methicillin Resistant Staphylococcus aureus - MRSA • Transmitted endogenously and exogenously • Microorganism infection involves host defence evading mechanisms including http://image.made-in-china.com/43f34j00aZutVjRdHDbo/Endotracheal-Tube-With-Suction-Catheter.jpg https://upload.wikimedia.org/wikipedia/commons/e/e4/Staphylococcus_aureus_biofilm_01.jpg

  9. MRSA - Antibiotic resistance • Resistance of S.aureus to antibiotics has occurred in prominent waves • Horizontal gene transfer, chromosomal mutations or antibiotic selection result in resistance to antibiotics • Vancomyin - slower rate of bacterial clearance and lower rate of clinical response than -lactam antibiotics

  10. Rates of MRSA infections in England • 35% reduction in cases from 2009-2010 • 42% reduction observed between the years of 2003-04 (7,700 cases) and 2007-08, (4,450 cases)

  11. Regional Differences in MRSA Rates • Highest number of cases was in London • Lowest number of cases was in South Central and the North East • Highest average number of infections per hospital in Yorkshire and the Humber • Lowest average number of infections per hospital in the West Midlands

  12. Demographics by region

  13. Influence of Regional Population and Population Density on MRSA Rates

  14. Influence of Life Expectancy on MRSA Rates

  15. Influence of Regional Average Earnings on MRSA Rates

  16. Influence of Age on MRSA Rates

  17. Comparison between hospitals with high rates MRSA bacteraemia and those with low rates

  18. Influence of Size of Hospitals on MRSA Rates

  19. Influence of Gender on MRSA Rates

  20. Conclusions • Many contributing factors for rates of MRSA • Hospital size • Further research: • Specialisation of trusts • Staff to patient ratio • Prevention methods and techniques within individual hospitals

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