484. Stratified analysis of sources of MRSA bacteraemia to inform intervention strategy in the English National Health Service
Session: Poster Session: Hospital-acquired and Transplant Infections
Friday, October 30, 2009: 12:00 AM
Room: Poster Hall A
Background: Mandatory surveillance and public reporting of hospital acquired infection was introduced in 2001 across the English NHS . In 2004 the Department Health (DH) formulated a performance management intervention programme focused on a 50% reduction in MRSA bacteraemia: a national target that was achieved by June 2008. This paper describes the lessons learned from analysing the sources of MRSA bacteraemia stratified by time of detection.
Methods: All cases of MRSA bacteraemia diagnosed in the English NHS are required to be reported using a real time web-enabled reporting system. The DH requires that NHS Trust CEOs sign off monthly returns fourteen days after the end of each month at which time the Trust dataset is locked. Repeat positives within a 14 day period are not required to be reported. All other laboratory reports of MRSA isolated from blood cultures are required to be reported: e.g. contaminants, work undertaken for the non-acute sector of the NHS and bacteraemia cases detected prior to admission. In addition to the mandatory reporting of case numbers and demographics Trusts can submit information on source and risk factors on a voluntary basis. This analysis reports the presumptive sources for 4836 cases of MRSA bacteraemia in relation to the time of detection, stratified as prior and after two days from hospital admission of the case.
Results: Table 1 Sources of MRSA bacteraemia in England 2006-8 stratified by time of detection
Timing of
Detection
Vascular
lines
Other
devices
SSTSSIUTIOther
Local
Infect.
Contam
- inants
OtherTotal
Within 2 days &
on presentation
2541635483169231113691289
On Presentation87863831392013269
Pre 2 days16782917513819293561020
Post 2 days93154391139132266151903495
Not Categorised210124446152
Total cases120670757226305501270160

Discussion and Conclusion: The results provide an evidence base for targeting interventions for both hospital and community associated cases.
Andrew Pearson, MD, Health Protection Agency and  A. D. Pearson, None..
A. D. Pearson, None.