MRSA cases fall but caution urged over new figures

THE NUMBER of cases of MRSA bloodstream infection reported in the first six months of this year have fallen when compared with…

THE NUMBER of cases of MRSA bloodstream infection reported in the first six months of this year have fallen when compared with the same period last year.

The figures, released yesterday by the national Health Protection Surveillance Centre (HPSC), show 240 cases reported in the first six months of 2008 compared to 292 in the first six months of 2007.

The largest number of cases reported by a single hospital in the first half of this year - 25 in all - were reported at Dublin's Beaumont Hospital. Some 23 cases were reported at Galway University Hospitals and 22 at St James's Hospital, Dublin.

A number of hospitals reported no cases and St Columcille's Hospital in Loughlinstown, Dublin - where concerns about infection rates have been raised at a number of inquests - failed to provide figures.

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Dr Robert Cunney, a consultant microbiologist with the HPSC, said he was pleased to see a reduction in the number of MRSA bloodstream infections this year but urged caution in interpreting the findings as it is not yet clear whether or not this downward trend will continue.

He said that although the downward trend may be significant, it is not yet known if it is due to improved infection prevention and control interventions, or due to strains of MRSA becoming less likely to cause infection, or some other explanation.

Improved infection prevention and control interventions are unlikely to fully explain the overall reduction in MRSA bloodstream infections, he said, because the number of infections caused by other antibiotic-resistant bacteria has not declined and the number of reported meticillin-sensitive Staph aureus (MSSA) infections has not declined. Furthermore the level of hospital antibiotic use remains at a high level compared to other European countries.

Dr Cunney said a lot more needs to be done to reduce the rate of infections caused by antibiotic-resistant bacteria, including MRSA. Other European countries have lower rates, he said.

"Investment in infection prevention and control structures, and in interventions to limit inappropriate antibiotic use, can bring major cost savings to the health service but, more importantly, will also save lives," he said.

He added that a number of other infections are showing an increased resistance to drugs. These include Streptococcus pneumoniae - the most common cause of pneumonia outside of hospitals and an important cause of meningitis in young children - E.coli which causes kidney infections, and vancomycin-resistant enterococcus (VRE).

Ireland has the second-highest reported rate of VRE in Europe. Antibiotic use and inadequate infection preventions and controls are the most likely explanations.

The latest figures show that in addition to cases of MRSA dropping, the percentage of Staph aureus being reported which is resistant to methicillin is also down 3.5 per cent in the first six months of 2008 when compared with the first half of 2007, and down 7 per cent when compared with the first half of 2006.

MRSA can be fatal if it enters the bloodstream through open wounds.