A million hospital patients a year contract infection that makes them more ill

A million hospital patients a year contract infection that makes them more ill

A snapshot survey carried out  in England last October and November shows what unhealthy places hospitals are.  One in sixteen of the 14.9 million patients admitted in 2011 was found to have an infection such as MRSA or C Difficile which they contracted while in hospital.

The figure is an improvement on the past. The infection rate has fallen 22 per cent since the last survey in 2006. But the Health Protection Agency, which carried out the survey, said that as MRSA and C Difficile rates had fallen, other infections such as Salmonella and E Coli had risen.

Professor Anthony Kessel, medical director of the HPA said: “There are new challenges to meet.”

Collectively known as Healthcare Associated Infections the bugs that invade hospital in-patients claim thousands of lives and cost the NHS an estimated £1billion a year. In 2006 MRSA and C Difficile were together claiming  5,000 lives a year but bloodstream infections caused by these bugs have since be en reduced 18 fold for MRSA and five fold for C Difficile. 

In their place, a new group of bacteria called Enterobacteriaceae have risen and now account for a third of all HealthCare Associated Infections. These bugs, including salmonella and E Coli, are found in the environment and in the human gut and only cause a problem when they migrate to other sites in the body such as the respiratory and urinary systems or a surgical wound.

The highest rates are in the sickest patients in intensive care where almost a quarter (23.4 per cent) of patients are infected. Those patients who have devices inserted such as catheters,  or have surgery performed, are at highest risk.

In the past doctors regarded HCAIs as an inevitable side effect of hospital treatment which could be treated with antibiotics, and tended to neglect infection control measures such as washing hands.  Public and political outrage at the high rates of infection, fuelled by scandals at Stoke Mand eville and Maidstone and Tunbridge Wells hospitals where scores of patients died in C Difficile outbreaks, led to a drive to reduce infection levels.

Experts now warn that despite its success, there is more to be done. Antibiotic resistance is rising making infections more difficult to treat and there are no new antibiotics on the horizon. 

Over 50,000 NHS and 1,600 private patients were surveyed in 103 hospitals. The results showed 6.4 per cent of patients had an HCAI, down from 8.2 per cent in 2006. The most common were infections of the respiratory tract such as pneumonia, the urinary tract and surgical sites.

 Private hospitals had a lower infection rate than the NHS at 2.2 per cent, but they do not treat emergencies, have fewer beds and shorter lengths of stay.

 Susan Hopkins, a healthcare epidemiologist and auther of the report  said:”One in 16 patients in hospital at any one time has an HCAI. That is about one million. But that is the pre valence, not the incidence. Because they tend to be sicker and stay in hospital longer the risk of contracting an HCAI is lower at between 1 and 2 per cent.”

About a quarter of patients arrive in hospital with an HCAI caught in another healthcare facility elsewhwere, with the remainder contracting the infection where they are treated.

Dr Hopkins added: “Enterobacteriaceae (also known as coliforms), have increased - they have been slowly and surely rising over the last ten years and now account for a third of all infections. It is clear that we need to find ways to control and prevent transmission of these bacteria and this is an important priority.”