Download Deaths linked to C. difficile and MRSA drop by over one third

Deaths linked to C. difficile and
MRSA drop by over one third
Date: 24 August 2010
Coverage: England and Wales
Theme: Health and Care
The number of deaths from two of the most high profile healthcare associated infections
has dropped considerably over the last year according to figures released today by the
Office for National Statistics.
Deaths involving Clostridium difficile (C. difficile) fell by 34 per cent between 2008 and
2009 from 5,931 to 3,933. Similarly deaths involving meticillin-resistant Staphylococcus
aureus (MRSA) went down by 37 per cent, dropping from 1,230 to 781.
During 2005-2009 the over 85s had the highest C. difficile death rates of 2,349 per million
population for males and 2,363 per million for females. Rates were lowest in the under-45
age group with less than one death per million for each sex.
Similarly it was the over 85’s which accounted for more deaths from the MRSA infection
with a rate of 621.7 deaths per million population for males and 307.3 per million for
females. Like C. difficile, rates were lowest among the under-45’s with one death per
million for both sexes.
Rates for deaths involving C. difficile are similar for males and females. Figures increased
each year from 2001 until 2007 where they peaked at 84.7 per million for men and 80.4
million for women. Rates decreased in 2008 and continued to fall in 2009 to 38.8 per
million and 36.9 per million for males and females respectively.
Deaths mentioning MRSA are higher among males than females. Male rates peaked at
26.8 per million population in 2006 and have since decreased, falling by 36 per cent
between 2008 and 2009 to 11.7 million. For females, rates were highest in 2005 at 14.4
per million. In 2009, the rate decreased to 5.9 per million from 10.3 per million in 2008.
News release: Deaths linked to C. difficile and MRSA drop by over one third | Page 2
Background Notes
1. Clostridium difficile (C. difficile): is a spore forming bacterium which is present as one of the
‘normal’ bacteria in the gut of up to 3 per cent of healthy adults (Knoop et al. 1993). It is much
more common in babies – up to two thirds of infants may have C. difficile in the gut, where it
rarely causes problems. C. difficile can cause diarrhoea, ranging from a mild disturbance to
very severe illness with ulceration and bleeding from the colon (colitis), and perforation of the
intestine leading to peritonitis, which can be fatal (Bartlett 1990). C. difficile disease occurs
when normal, healthy intestinal bacteria are subdued by the use of antibiotics. This allows C.
difficile to flourish in the gut and produce a toxin that causes diarrhoea. People over the age of
65 years are more susceptible to contracting infection.
2. Staphylococcus aureus (S. aureus): This is a common germ that lives completely harmlessly
on the skin and in the nose of about one third of the population. It is more common on skin that
is broken, for example, by a cut or sore. People who have S. aureus on or in their body but who
are unharmed by it are described as colonised. S. aureus can cause problems when it gets
the opportunity to enter the body. This is more likely to happen in people who are already
unwell.
3. Meticillin-resistant Staphylococcus aureus (MRSA): This is a variety of S. aureus that is
resistant to meticillin (a type of penicillin), and some of the other antibiotics that are usually
used to treat S. aureus. This sometimes makes it more difficult to treat MRSA infections.
4. The number of deaths due to C. difficile and MRSA is difficult to estimate. Trends in mortality
are usually monitored using the underlying cause of death (the disease which initiated the train
of events leading directly to death). However, C. difficile and MRSA are often not the
underlying cause of death. Those who die with C. difficile or MRSA are usually patients who
were already very ill, and it is their existing illness, rather than C. difficile or MRSA, which is
often designated as the underlying cause of death. There is therefore an interest in the number
of deaths where C. difficile and MRSA contributed to the death – only conditions which
contribute directly to the death should be recorded on the death certificate.
5. For further details on deaths involving Clostridium difficile in England and Wales, please see
the Statistical Bulletin and dataset available at:
http://www.statistics.gov.uk/StatBase/Product.asp?vlnk=14782
6. For further details on deaths involving MRSA in England and Wales, please see the Statistical
Bulletin and dataset available at:
http://www.statistics.gov.uk/StatBase/Product.asp?vlnk=13571
7. Details of the policy governing the release of new data are available from the Media Relations
Office.
8. National Statistics are produced to high professional standards set out in the Code of Practice
for Official Statistics. They undergo regular quality assurance reviews to ensure that they meet
customer needs. They are produced free from any political interference.
© Crown copyright 2010.
News release: Deaths linked to C. difficile and MRSA drop by over one third | Page 3
References
Bartlett, J.G. (1990) ‘Clostridium difficile: clinical considerations’, Reviews in Infectious Diseases 12
Supplement 2, S243–S251.
Knoop, F.C., Owens, M. and Crocker, I.C. (1993) ‘Clostridium difficile: clinical disease and
diagnosis’, Clinical Microbiology Reviews 6 p 251
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Issued by: Office for National Statistics, Government Buildings, Cardiff Road, Newport NP10 8XG
Media contact:
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Jim Campbell
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Lynsey Kyte
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Website:
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