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Bacteraemia Report for Trust B For Trust B during the past year, the significant bacteraemia are listed in the top ten organisms list below. There has been little change since reporting from the last quarter in the ranks. Coagulase negative staphylococci remain the most commonly isolated organism. While some of these will undoubtedly be false positives (such organisms are common skin organisms), the large number, approximately 45% of all isolates, is probably a reflection of modern healthcare where we rely heavily on IV access. These organisms commonly colonise the line and are picked up during sampling. These organisms from such sites can cause clinical illness, particularly in ITU or high dependency patients. Our infection reduction target is currently aimed at improving IV line management and it will be this marker that we will be watching over the coming months to see if we can achieve an overall reduction in bacteraemias and specifically of this common organism. Our second highest organism is likely to be a reflection of urinary tract infection. MRSA is currently at number 5, up from number 6 in the previous quarter. This movement is probably not significant but you may view the specific information in relation to Staphylococcus aureus or MRSA from the nationally collated information. 1 April 03 – 31 March 04 Organism Staphylococcus coagulase negative Escherichia coli Staphylococcus aureus (MSSA) Enterococcus sp Staphylococcus aureus (MRSA) Streptococcus pneumoniae Corynebacterium sp Gram negative bacillus Klebsiella pneumoniae Serratia marcescens Others Total Count Rank 233 1(1) 70 2(2) 52 3(3) 38 4(4) 17 7(6) 21 5(5) 20 6(6) 17 7(9) 10 9(8) 9 10(-) 122 609 per 1000 bed days 2.10 0.63 0.47 0.34 0.25 0.19 0.18 0.15 0.09 0.08 1.10 5.80 Our trend data in relation to Staphylococci appears on the next page Staphylococcus aureus bacteraemia Trend data for Trust B 0.05 4 03 ar 0 03 -M A pr Ja n 03 -D ec 03 03 02 -S ep O ct Ju l0 2J un ar 0 3 02 A pr 02 -M 02 02 -D ec Ja n 01 -S ep O ct A pr 01 -M ar 0 2 02 0.00 ar 04 3 ec 0 03 -M pr A Ja n 03 -D 03 03 Se p O ct 02 - ar 03 2Ju n l0 Ju 2 ec 0 A pr 02 -D Ja n 02 -M 02 02 Se p ct 01 - O 1Ju n l0 Ju 01 -M ar 02 0.00 0.10 un 0.05 0.15 1J 0.10 0.20 l0 0.15 0.25 Ju 0.20 pr Moving annual rate of MSSA bacteraemias per 1000 bed days in Trust B Bacteraemias/1000 bed days 0.25 A Bacteraemias/1000 bed days Moving annual rate of MRSA bacteraemias per 1000 bed days in Trust B Staphylococcus aureus bacteraemia data by Specialty in Trust B Specialty ITU General Surgery GP Other Paediatrics General Medicine Gynaecology Trauma & Orthopaedics Old Age Psychiatry SA/1000 beds MRSA/1000 beds MSSA/1000 beds 4.38 3.13 1.25 0.44 0.31 0.13 0.39 0.00 0.39 0.28 0.07 0.21 0.25 0.11 0.14 0.10 0.00 0.10 0.02 0.02 0.00 0.02 0.02 0.00 Key Messages Surveillance shows that for every 100,000 patients occupying a bed for a night in a Welsh NHS Trust, 12 patients have an MRSA bacteraemia and 15 have an MSSA bacteraemia. For every 100,000 patients spending a night in a bed in Trust B, 25 patients have an MRSA bacteraemia and 47 have an MSSA bacteraemia. Rates of MRSA and MSSA for Trust X and for its major acute hospital are not significantly different from the overall rates for Wales. Trend data show downward trends for both MRSA and MSSA bacteraemias in Trust B, but they are not significant. Data by specialty show highest rates in ITU. The S. aureus bacteraemia rates for all specialties in Trust B are not significantly different from any other Trust in Wales.