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MRSA, or methicillin-resistant Staphylococcus aureus is a type of bacteria and probably the most well known type of healthcare-associated infection (HAI).

A mandatory surveillance scheme began in April 2001 for monitoring Staphylococcus aureus and MRSA, so it is difficult to be accurate about the scale of the problem before then.

What is certain is that rates increased at the start of the decade, but are now dropping after concerted efforts to tackle the issue.

From mandatory reporting of MRSA infections in the bloodstream, cases rose to a high of 7,684 in 2003-2004. The following year saw a fall to a record-low of 7,212 infections. The latest figures show there were 3,517 infections between October 2005 and March 2006 - a 2.5% drop.

Between 2003 and 2004, mentions of MRSA on death certificates increased from 955 to 1,168, according to data from the Office for National Statistics.

Putting this in context, it means that out of the 12 million people that go into hospital in a year, about 360 of them die directly of MRSA.

Despite the relatively small scale, this has led to numerous media reports of a soaring problem over the past three years and the Department of Health has reacted with various strategies including an action plan in 2004, the cleanyourhands campaign, the Matron’s Charter to empower matrons to clean up their hospitals, and a target to halve MRSA infection rates in the bloodstream by 2008.

Nurses say these approaches are good but the government also needs to understand that high bed occupancy rates, low staffing levels and A&E targets, have all contributed to the problem as they have helped to prevent proper infection control.

In March 2005 around 2,000 nurses who responded to a NT survey said they had insufficient resources or support to improve infection control.

Some trusts have done particularly well in reducing their MRSA rates such as Hammersmith Hospitals NHS Trust in London. The trust saw its MRSA rate fall by 35% between 2003-2004 and 2004-2005 by taking various approaches including improved cleanliness of environments, good clinical practice, awareness among every level of staff, and reducing bed moves.

For those not doing so well, they will have to improve from next year. The government passed the Health Act in July 2006, which gives powers for a hygiene code and a tougher inspection regime to improve standards of hygiene and infection control.

The code is due in the autumn, and trusts will start to make declarations of compliance with it from April of next year. The Healthcare Commission will be responsible for monitoring the code.

Updated: September 2006

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