The number of Methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia reported by and attributed to Sherwood Forest Hospitals NHS Foundation Trust, Nottingham University Hospitals NHS Trust in the past seven financial years (FYs) is provided in the table below. Total MRSA reports and acute trust attribution is also provided for England.

MRSA bacteraemia reported by and attributed to Sherwood Forest Hospitals NHS Foundation Trust, Nottingham University Hospitals NHS Trust (FY 2008/09 to FY 2014/15)

Source:

- Annual results from the mandatory MRSA reporting scheme (FY 2007/08 to 2014/15).

- Accompanying data for annual epidemiological commentary: MRSA, MSSA and E. coli bacteraemia and C. difficile infection data, up to and including financial year 2014 to 2015

This data is not case-mix adjusted (i.e. they do not take into account the different population types served by each hospital) and so are not directly comparable. It is important to note that MRSA bacteraemia cases are reported by the acute trust whose laboratory processes the specimen and this may not always reflect where the bacteraemia was acquired.

Public Health England is working, with partner organisations, to address antimicrobial resistance through the implementation of the UK Five Year Antimicrobial Resistance Strategy[1].

[1] https://www.gov.uk/government/publications/uk-5-year-antimicrobial resistance-strategy-2013-to-2018

Public Health England (PHE) is unable to provide the number of recorded Methicillin Resistant Staphylococcus Aureus (MRSA) infections by borough/district.

PHE is able to provide this information by clinical commissioning groups (CCGs) and acute trusts.

Table 1 details counts/rates of total MRSA bacteraemia reported by Havering, Barking and Redbridge University hospitals trust and Table 2 lists counts/rates of MRSA bacteraemia attributed to Havering CCG over the last three financial years.

It is important to note that MRSA bacteraemia cases are reported by the acute trust whose laboratory processes the specimen and that this may not always reflect where the bacteraemia was acquired. Counts/rates for total MRSA bacteraemia reported in other CCGs and acute trusts in England is attached and can be found on the gov.uk website:

https://www.gov.uk/government/statistics/mrsa-bacteraemia-annual-data

PHE is working, with partner organisations, to address antimicrobial resistance through the implementation of the ‘UK Five Year Antimicrobial Resistance Strategy’¹.

Table 1: Financial year counts and rates of total MRSA bacteraemia reported by Havering, Barking & Redbridge University hospitals (FY 2012/13 to FY 2014/15)

Source: PHE July 2015 annual publication of surveillance data

Notes:

Bed days were calculated using KH03 data for the stated period. The average daily bed occupancy for the Trust quoted has been multiplied by the number of days in the time period. Rate per 100,000 bed days is calculated as follows:

Calculation of rate (per 100,000 bed days) = [Number of MRSA bacteraemia reports from the trust for the time period divided by Average daily bed occupancy multiplied by Number of days in the time period] multiplied by 100,000

NB: Included KH03 data are as of April 2015. KH03 data for January to March 2015 were not available at this time. Data for the same quarter last year (January to March 2014) has been used in FY 2014/15 bed day calculation.

Table 2: Financial year counts and rates of MRSA bacteraemia attributed to Havering CCG (FY 2012/13 to FY 2014/15)

Source: PHE July 2015 annual publication of surveillance data

Notes: CCG Populations are based upon Office for National Statistics (ONS) Mid-Year Population Estimates (2011 Census based). The relevant rate per 100,000 population was calculated as follows:

Calculation of rate (per 100,000 bed days) = [Number of MRSA bacteraemia reports from that CCG for the given time period divided by CCG level population estimate] multiplied by 100,000

NB: Included population data are as of April 2015. 2014 population estimates were not available at this time. 2013 population estimate data has been used as a proxy for the FY 2014/15 population.

Livestock-associated meticillin resistant Staphylococcus aureus (LA-MRSA) has been found worldwide and is not the same as the MRSA strains that normally cause healthcare-associated infections. If meat is stored, handled and prepared properly, the risk to people is very low and there are no known cases of people contracting LA-MRSA from eating meat.

The annual progress report and implementation plan for the UK five-year Antimicrobial Resistance Strategy includes the measures on animal health to be taken over the next four years to promote the responsible use of antibiotics. This is attached and available at:

https://www.gov.uk/government/publications/progress-report-on-the-uk-five-year-amr-strategy-2014

Regarding LA-MRSA specifically, there are a number of initiatives to reduce the risk, for example, Public Health England regularly reminds diagnostic laboratories of the need for continued vigilance and ensuring that MRSA isolates are submitted for further tests if there may be an association with farming. In addition, Defra and the Veterinary Medicines Directorate are leading a review of options for increased surveillance, which will be proportionate to the low public health risk. Defra is also considering additional guidance for farmers on how to reduce the risk of importing LA-MRSA into their farm. Furthermore Defra have previously worked with the National Pig Association and recommend that anyone importing breeding pigs and semen to Britain should have them screened for MRSA before importation.

The most common type of LA-MRSA in Europe belongs to clonal complex 398 (CC398). MRSA CC398 is less virulent and transmissible compared to other strains and is unlikely to pass from person to person and become endemic in the human population.

However studies from various countries in continental Europe have demonstrated that in limited circumstances it is possible for MRSA CC398 to be transmitted from animals to people. This tends to be constrained to those who have regular contact with livestock that are carrying the bacteria, in particular pigs.

The Advisory Committee on the Microbiological Safety of Food (ACMSF) sub-group on antimicrobial resistance (AMR) has been considering an assessment of the risk to consumers from MRSA in the food chain. Based on current evidence, the risk of contracting MRSA through consumption of foodstuffs is considered to be very low. This will be kept under review. Food Standards Agency food hygiene advice remains the same, i.e. that foodstuffs should be stored appropriately, handled hygienically and meat should be cooked thoroughly.