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Clostridium

Answer

Death certificate data published by Office for National Statistics (ONS) covers all certificates where methicillin-resistant Staphylococcus aureus (MRSA) or clostridium difficile (C. difficile) is cited as a contributory factor to or an underlying cause of death. Death certificates do not record the place where an infection was acquired.Many patients who become infected with a healthcare associated infection (HCAI) have other serious and potentially fatal underlying medical conditions. Doctors do not record all diseases or conditions present at death, only those that contribute directly to it. It is a matter of individual professional judgment whether the doctor lists an HCAI as a contributory cause and this will depend, generally, on whether the doctor thinks that the patient would have survived significantly longer if they had not developed an infection.There has been a number of initiatives to raise the profile of HCAIs and improve their acknowledgement as diagnoses in their own right. In July 2005 and October 2007 the chief medical officer reminded doctors of the importance of giving full and accurate information on the death certificate, particularly in recording HCAIs.Table 1 provides regional data on the number of death certificates on which C. difficile was mentioned for 1999 and 2001 to 2007.Table 2 provides regional data on the number of death certificates on which MRSA was mentioned from 1997 to 2007.NHS acute trusts are required to report all C. difficile toxin positive faecal specimens and all MRSA positive blood cultures processed by their laboratories, whether clinically significant or not and whether acquired in that trust or elsewhere.Tables 3 to 5 provide data on mandatory surveillance data for C. difficile and MRSA.Mandatory surveillance of C. difficile infection for patients aged 65 years and over began in January 2004. Table 3 provides regional data on the number of recorded C. difficile cases for patients aged 65 years and over by calendar year 2004 to 2007.Mandatory surveillance of C. difficile infection was extended to include data for all patients aged two years of age and over in April 2007. Table 4 provides regional data on the number of recorded C. difficile cases for patients aged 2-64 from April 2007 to March 2008.Mandatory surveillance of MRSA bacteraemia (or bloodstream infections) began in April 2001. Table 5 provides regional data on the number of recorded MRSA bacteraemia cases by financial year from 2001-02 to 2007-08. There is no mandatory surveillance of non-bacteraemia MRSA infections, these present a significantly lower risk in terms of patient safety.All tables have been placed in the Library.

Secondary information

Type

Written question

Reference

223356; 479 c1882-3W

Session

2007-08

Subjects

MRSA Clostridium

Link

View this Written question on www.publications.parliament.uk