Patients are seven times more likely to die due to HCAI
Experts say appropriate discharge could reduce infection
20th April 2010 – A new report launched today "Meticillin-Resistant Staphylococcus aureas (MRSA) in Ireland: Addressing the Issues" estimates that MRSA infection in Irish hospitals costs in excess of €23 million annually. The report, launched at the Royal College of Physicians (RCPI) was developed by a multidisciplinary advisory group including microbiologists, hospital pharmacists and patient advocates and funded by an unrestricted educational grant from Pfizer.
The main factor contributing to the cost is the increased length of stay by patients in the hospital. Patients with a healthcare associated infection (HCAI) spend on average an additional 11 days in hospital and the attendant treatment costs also increase. The above cost for MRSA infection represents 10% of the total cost of additional expenditure as a result of all HCAI which is estimated at €233.75 million annually. It is estimated that approximately one third of HCAIs are preventable, therefore the potential savings from all HCAI is €77 million and the potential saving from MRSA infection is €7.6 million.
Speaking at the launch Dr Edmond Smyth, Consultant Microbiologist, Beaumont Hospital and Chairperson of the MRSA Group said: "There is good evidence that the burden of MRSA infection in Ireland is greater than in most other European countries and while there are some positive indications that infection rates are declining, MRSA infection is still a major issue resulting in illness and in some cases death. The many initiatives underway are to be welcomed: specifically microbiology laboratory accreditation, improved surveillance and feedback of infection rates and the appointment of additional consultant microbiologists, infection prevention and control nurses and antimicrobial pharmacists have all played a significant role. However, other measures such as early discharge and out-patient treatment present further opportunities both in terms of quality of life for patients but also in terms of cost. The evidence shows that discharging patients earlier reduces the risk of infection which would ultimately reduce illness and death rates."
In addition to the increased cost of managing HCAIs, there is a significant impact on patients' recovery, quality of life and death. The report estimates that patients who acquire an infection in hospital stayed in hospital 2.5 times longer than other patients. Most significantly, they are 7.1 times more likely than uninfected patients to die in hospital.
Stephen McMahon, CEO of the Irish Patients' Association and member of the MRSA Group said: "The increased public attention about MRSA infection has resulted in a number of key guidelines and measures being introduced which may be having some beneficial effect. However, Ireland still has one of the highest rates of MRSA infection in Europe so it is vital that this continues to be a key item on the patient safety and quality agenda and that other initiatives such as measures to ensure patients can be discharged when medically fit are looked at."
According to the European Antimicrobial Resistance Surveillance System (EARSS), data, Ireland ranks fourth in Europe for MRSA bloodstream infection (BSI) rates at 33.1%, with only Portugal, Greece and Italy ahead. There were 1,240 reports of S. aureus bloodstream infections in Ireland in 2008, 33.9% of these were MRSA. The provisional data for Q.1 – Q.3 2009 shows a decline to 28%. This is the lowest level since surveillance began in 1999 and is to be cautiously welcomed pending confirmation of the trend over a longer surveillance period. However, it should be remembered that the rate in this country is significantly higher than in many other EU countries.
HCAI occurs due to both patient and non-patient factors. Patient factors include extremes of age, the presence of surgical and other wounds, the use of medical devices such as catheters and drains, severity of illness, co-morbidities, length of hospital stay and recent surgery or ICU care. Hospital factors include poor hand-hygiene compliance, widespread use of antimicrobials, contaminated equipment, a poorly maintained hospital environment, delay in patient isolation, staff-patient ratios and the adequacy of both the hospital infrastructure and isolation facilities.
Published: 20th April 2010.