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Healthcare Associated Infection Bimonthly Report July 2015
Section 1 – Board Wide Issues
Key Healthcare Associated Infection Headlines • The Infection Prevention and Control Team has completed a year of an NHS Grampian wide programme
of supported environmental audits. This programme was set up to support Senior Charge Nurses and Clinical Departmental Managers to carry out their environmental audits with support around applying consistent levels of scrutiny of cleaning and measuring compliance with standard infection control precautions (SICPs). A review of the audit tool (in light of the publication of the new HAI standards) is under way.
• Over 300 delegates attended the 7th annual Infection Prevention and Control conference - Champions Challenged - at the Aberdeen Exhibition and Conference Centre on 23 June. Several international speakers presented including Professor Hugo Sax (the developer of the 5 moments for hand hygiene international standard), alongside our very own Professor Rona Patey and our Lead Infection Prevention and Control Doctor, Anne Marie Karcher. Twitter is a fantastic way to get immediate feedback and we hit the mark with an impressive 777 tweets on the day including: “Really excellent #championschallenged fab speakers. Well done”, “Well done for an excellent event” and “Huge congratz to all involved in planning a brilliant event today”. To read all the tweets search #championschallenged and to keep up to date with infection prevention and control news follow @NHSG_IPC.
• A new surgical site infection (SSI) surveillance module of the current Infection Prevention and Control clinical management system (ICNet) successfully went live on 2 July. Apart from increasing automation of data collection of wound infections following Caesarian section, and hip and knee replacements (arthroplasties), the hope is that surgical teams can monitor all wound infections in time.
• We have been asked to participate in the development of a new national campaign around cleanliness of
the environment and equipment. As well as a public facing element, this campaign is likely to mirror the Hand Hygiene Campaign of 2007.
• As chair of the Scottish National Infection Prevention and Control Managers network, the Infection
Prevention and Control Manager now sits on the HAI Task Force. This will improve NHS Grampian’s ability to horizon scan and predict future government policy.
• The Woodend Hospital HAI Group are piloting an audit tool for identifying all non-compliant hand
hygiene basins. This will allow robust risk assessment and prioritisation of replacements as funding is identified.
• Mental Health and Learning Disability have implemented a comprehensive system of management-led
environmental audits.
This section of the HAIRT covers Board wide infection prevention and control activity and actions. For reports on individual hospitals, please refer to the ‘Healthcare Associated Infection Report Cards’ in Section 2. A report card summarising Board wide statistics can be found at the end of section 1
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Staphylococcus aureus (including MRSA)
Staphylococcus aureus Bacteraemia Surveillance Health Protection Scotland published their quarterly reports on the surveillance of Staphylococcus aureus bacteraemia (SAB) in Scotland, January - March 2015 on 7 July 2015. The following table and graphs demonstrate NHS Grampian’s rate of SABs compared with all other Boards in Scotland. The January -March 2015 quarter showed a reduction in the number of SABs from 39 to 28. This translates as a rate reduction from 30.4 SABs per 100,000 AOBDs to 21.1 SABs per 100,000 AOBDs. This means that the NHSG SAB rate for this quarter was below the national average of 29.7. NHSG has consistently come in above, or just on the trajectory, since a SAB HEAT Target trajectory was introduced (June 2011). A rate exactly equal to trajectory has been achieved but a rate below trajectory has never been recorded. It is of note that a significant proportion of SABS are ‘out-of-hospital’ and some of these SABs are associated with intravenous drug use. There was no statistically different change in SAB rates between 2014 and 2015. Each new case continues to be discussed at a weekly multidisciplinary team meeting involving Infection Prevention and Control Doctor(s), Infection Prevention and Control Nurses, Surveillance Nurse, Antimicrobial Pharmacist, Infection Unit Nurse and a microbiology registrar. If any issues are identified, a meeting is held with staff from the area concerned, and an SBAR is produced. A graph showing surveillance data from June 2005 (when this surveillance programme commenced) demonstrates a reduction in the rate of MRSA bacteraemia but no statistically significant reduction in MSSA bacteraemias. The following measures have been put in place: • Testing of a new system for providing feedback to clinical teams continues. • Work has commenced on standardising paperwork for recording insertion and maintenance of peripheral
vascular catheters (PVCs) across NHS Grampian. This has been rolled out across Dr Gray’s Hospital and is now being tested in Royal Aberdeen Children’s Hospital.
Staphylococcus aureus is an organism which is responsible for a large number of healthcare associated infections, although it can also cause infections in people who have not had any recent contact with the healthcare system. The most common form of this is Meticillin Sensitive Staphylococcus Aureus (MSSA), but the more well known is MRSA (Meticillin Resistant Staphylococcus Aureus), which is a specific type of the organism which is resistant to certain antibiotics and is therefore more difficult to treat. More information on these organisms can be found at:
Staphylococcus aureus : http://www.nhs24.com/content/default.asp?page=s5_4&articleID=346
MRSA: http://www.nhs24.com/content/default.asp?page=s5_4&articleID=252
NHS Boards carry out surveillance of Staphylococcus aureus blood stream infections, known as bacteraemias. These are a serious form of infection and there is a national target to reduce them. The number of patients with MSSA and MRSA bacteraemias for the Board can be found at the end of section 1 and for each hospital in section 2. Information on the national surveillance programme for Staphylococcus aureus bacteraemias can be found at: http://www.hps.scot.nhs.uk/haiic/sshaip/publicationsdetail.aspx?id=30248
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S aureus bacteraemia cases and incidence rates (per 100 000 Acute Occupied Bed Days): Q4 2014 (October to December 2014) compared to Q1 2015 (January to March 2015) Quarter 4 2014
Quarter 1 2015
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Funnel plot of SAB rates (per 100 000 AOBDs) for all NHS Boards in Scotland in Q1 2015
Funnel plot of MRSA bacteraemia rates (per 100 000 AOBDs) for all NHS Boards in Scotland in Q1 2015
Funnel plot of MSSA bacteraemia rates (per 100 000 AOBDs) for all NHS Boards in Scotland in Q1 2015
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S aureus bacteraemia rates (per 100 000 acute occupied bed days) NHS Grampian
Clostridium difficile
Clostridium difficile Infection Surveillance Health Protection Scotland also published their quarterly reports on the surveillance of Clostridium difficile infections (CDIs) in Scotland, January – March 2015 on 7 July 2015. The following tables and graphs demonstrate NHS Grampian’s rates of CDI compared with all other Boards in Scotland, with data broken down for age groups >65 years and 15-64 years. NHSG has consistently met the HEAT Target for CDI. The January-March 2015 quarter showed a reduction in the number of Clostridium difficile infections in patients aged 65 or over from 28.7 per 100,000 total occupied bed days (OBDs) to 25.9 per 100,000 total occupied bed days (OBDs). The rate in patients aged 15-64 remained unchanged at 23.4 per 100,000 total occupied bed days (OBDs). Graphs showing surveillance data from 2006 (patients over 65 years old) and 2009 (15-64 years old) demonstrate the downward trend in CDI rates over both age groups over time. As with S aureus bacteraemias, each new case is discussed at a weekly multidisciplinary team meeting involving Infection Prevention and Control Doctor(s), Infection Prevention and Control Nurses, Surveillance Nurse, Antimicrobial Pharmacist, and a microbiology registrar – the Infection Unit Nurse is not present for the CDI case discussions. By close investigation of each case and typing of the organisms – when indicated – the Infection Prevention and Control Team is assured that the recent increase in infections is not due to any outbreaks.
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mrsa_rate mrsa_lower_CI mrsa_upper_CImssa_rate mssa_lower_CI mssa_upper_CIsab_rate sab_lower_CI sab_upper_CI
Clostridium difficile is an organism which is responsible for a large number of healthcare associated infections, although it can also cause infections in people who have not had any recent contact with the healthcare system. More information can be found at: http://www.nhs.uk/conditions/Clostridium-difficile/Pages/Introduction.aspx
NHS Boards carry out surveillance of Clostridium difficile infections (CDI), and there is a national target to reduce these. The number of patients with CDI for the Board can be found at the end of section 1 and for each hospital in section 2. Information on the national surveillance programme for Clostridium difficile infections can be found at: http://www.hps.scot.nhs.uk/haiic/sshaip/ssdetail.aspx?id=277
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CDI cases and incidence rates in patients aged 65 years or over: Q4 2014 (October to December 2014) compared to Q1 2015 (January to March 2015)
CDI cases and incidence rates in patients aged 15-64 years: Q4 2014 (October to December 2014) compared to Q1 2015 (January to March 2015)
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Funnel plot of CDI incidence rates (per 100 000 TOBDs) in patients aged 65 years and over for all NHS boards in Scotland in Q4 2014
Funnel plot of CDI incidence rates (per 100 000 TOBDs) in patients aged 15-64 years for all NHS boards in Scotland in Q4 2014
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Quarterly rates of Clostridium difficile 65+ per 100 000 total Bed days
CDI 65+ rate
CDI 65+_lower_CI
CDI 65+_upper_CI
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200 Quarterly rates of Clostridium difficile 15-64 per 100 000 total
Bed days CDI 15-64 rate CDI 15-64_lower_CI
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250 Quarterly rates of Clostridium difficile 15+ per 100 000 total Bed
days CDI 15+ rate
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Hand Hygiene The NHS Hand Hygiene Campaign came to a close in August 2013. NHS Boards are now required to publish ward/clinical area level self audit data. The results of approximately 150 self audits are contained within the scorecards towards the end of this report and are the collated audits results from all clinical areas in NHS Grampian. While the campaign has finished, there is still the requirement to quality assure ward level self audits of hand hygiene. During the months of April and May 28 quality assurance audits were carried out by the Infection Prevention and Control Team. These were conducted in a range of healthcare settings and across all the sectors. 16 of 28 audits resulted in a compliance score of 90% or above, the national target. All areas that achieved a score of less than 90% (12) held a problem assessment meeting to establish the contributory causes and develop an action plan. Contributory causes have included non-compliance with dress code, differences in application of hand hygiene audit methodology and placement of hand hygiene products. Re-audits take place once all the actions have been completed. The disparity between local audit data and quality assurance audit results is discussed at all problem assessment group meetings and often is the result of inconsistency in the application of hand hygiene audit methodology. Further investigation is ongoing to clarify all contributory factors. Cleaning and the Healthcare Environment
Good hand hygiene by staff, patients and visitors is a key way to prevent the spread of infections. More information on the importance of good hand hygiene can be found at:
http://www.washyourhandsofthem.com/
NHS Boards monitor hand hygiene and ensure a zero tolerance approach to non compliance. The hand hygiene compliance score for the Board can be found at the end of section 1 and for each hospital in section 2. Information on national hand hygiene monitoring can be found at: http://www.hps.scot.nhs.uk/haiic/ic/nationalhandhygienecampaign.aspx
Keeping the healthcare environment clean is essential to prevent the spread of infections. NHS Boards monitor the cleanliness of hospitals and there is a national target to maintain compliance with standards above 90%. The cleaning compliance score for the Board can be found at the end of section 1 and for each hospital in section 2.
This report covers the cleaning functions carried out by domestic staff and estates staff. As one part of their duties domestic staff clean parts of the ward environment like the floors, toilets, sinks etc. They also clean other areas of the healthcare facility such as corridors, offices, foyer etc. They generally do not clean near patient equipment e.g. the patient bed tray, the upper half of the patient bed or drip stands etc. In the context of this report, estates cleaning refers to the fabric of the building e.g. vents, walls, ceiling tiles etc. This report does not present information on the whole of the estates function e.g. water systems, heating, ventilation etc across all healthcare facilities. Information on national cleanliness compliance monitoring can be found at: http://www.hfs.scot.nhs.uk/online-services/publications/hai/
Healthcare environment standards are also independently inspected by the Healthcare Environment Inspectorate. More details can be found at: http://www.nhshealthquality.org/nhsqis/6710.140.1366.html
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Since the last report, the Healthcare Environment Inspectorate published their report of the unannounced inspection of Dr Gray’s Hospital on 14 and 15 April 2015. Overall, the inspectors found evidence that NHS Grampian is complying with the majority of NHS QIS HAI standards to protect patients, staff and visitors from the risk of acquiring an infection. In particular: • There was a good standard of environmental cleanliness in the hospital • Staff had good knowledge of isolation procedures, and • They saw generally good compliance with standard infection control precautions (SICPs). However, the inspectors did find that further improvement is required in the following areas: • Staff’s knowledge of how to safely manage blood spillages • Clinical waste must be appropriately stored while awaiting uplift, and • Adherence to NHS Grampian’s own local peripheral venous catheter (PVC) policy must be improved. A comprehensive action plan has been developed and is available, along with the full report, at: http://www.healthcareimprovementscotland.org/HEI.aspx Incidents and Outbreaks Norovirus Prevalence Monday Point Prevalence Surveillance figures are reported to Health Protection Scotland. These capture the significant outbreaks of Norovirus in NHS Grampian and the prevalence of norovirus activity in close to real time. They are not, and should not be interpreted as data for benchmarking or judgement. The data can be used for the assessment of risk and norovirus outbreak preparedness only. During April and May no wards or bays were closed due to Norovirus during Monday Point Prevalence. Data on the numbers of wards closed due to confirmed or suspected norovirus are available from HPS on a weekly basis at: http://www.hps.scot.nhs.uk/haiic/ic/noroviruspointprev.aspx Other HAI Related Activity Surgical Site Infection (SSI) Surveillance NHS Grampian participates in the Surgical Site Infection (SSI) surveillance programme that is mandatory in all NHS boards in Scotland. All NHS boards are required to undertake surveillance for hip and knee arthroplasty and caesarean section procedures as per the mandatory requirements of HDL (2006) 38 and CEL (11) 2009. In addition NHS Grampian carries out surveillance for in-patient breast surgery. Readmission surveillance is carried out using prospective readmission data on orthopaedic and breast procedure categories under inpatient surveillance up to 30 days post operatively. Post discharge surveillance until day 10 post operation is also carried out for all caesarean sections performed. Last available quarter (1 January to 31 March 2015) Category of Procedure
Number of operations
Number of Infections
NHS Grampian SSI rate (%)
National dataset SSI rate (%)
Caesarean section
396
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2
1.2
Hip arthroplasty
221
2
0.9
0.9
10
Knee arthroplasty
188 0 0.0 0.
Investigations into why the NHS Grampian rate is higher than the Scottish average have revealed little of note except that a high proportion (5 out of 8) of patients were either overweight or obese. This appears to be an increasing trend amongst the risk factors for post C Section wound infection.
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Healthcare Associated Infection Reporting Template (HAIRT)
Section 2 – Healthcare Associated Infection Report Cards
The following section is a series of ‘Report Cards’ that provide information, for each acute hospital and key community hospitals in the Board, on the number of cases of Staphylococcus aureus blood stream infections (also broken down into MSSA and MRSA) and Clostridium difficile infections, as well as hand hygiene and cleaning compliance. In addition, there is a single report card which covers all community hospitals [which do not have individual cards], and a report which covers infections identified as having been contracted from outwith hospital. The information in the report cards is provisional local data, and may differ from the national surveillance reports carried out by Health Protection Scotland and Health Facilities Scotland. The national reports are official statistics which undergo rigorous validation, which means final national figures may differ from those reported here. However, these reports aim to provide more detailed and up to date information on HAI activities at local level than is possible to provide through the national statistics. Understanding the Report Cards – Infection Case Numbers Clostridium difficile infections (CDI) and Staphylococcus aureus bacteraemia (SAB) cases are presented for each hospital, broken down by month. Staphylococcus aureus bacteraemia (SAB) cases are further broken down into Meticillin Sensitive Staphylococcus aureus (MSSA) and Meticillin Resistant Staphylococcus aureus (MRSA). More information on these organisms can be found on the NHS24 website: Clostridium difficile : http://www.nhs24.com/content/default.asp?page=s5_4&articleID=2139§ionID=1 Staphylococcus aureus : http://www.nhs24.com/content/default.asp?page=s5_4&articleID=346 MRSA: http://www.nhs24.com/content/default.asp?page=s5_4&articleID=252§ionID=1 For each hospital the total number of cases for each month are those which have been reported as positive from a laboratory report on samples taken more than 48 hours after admission. For the purposes of these reports, positive samples taken from patients within 48 hours of admission will be considered to be confirmation that the infection was contracted prior to hospital admission and will be shown in the “out of hospital” report card. Targets There are national targets associated with reductions in C.diff and SABs. More information on these can be found on the Scotland Performs website: http://www.scotland.gov.uk/About/Performance/scotPerforms/partnerstories/NHSScotlandperformance Understanding the Report Cards – Hand Hygiene Compliance Hospitals carry out regular audits of how well their staff are complying with hand hygiene. Each hospital report card presents the combined percentage of hand hygiene compliance with both opportunity taken and technique used broken down by staff group. Understanding the Report Cards – Cleaning Compliance Hospitals strive to keep the care environment as clean as possible. This is monitored through cleaning and estates compliance audits. More information on how hospitals carry out these audits can be found on the Health Facilities Scotland website: http://www.hfs.scot.nhs.uk/online-services/publications/hai/ Understanding the Report Cards – ‘Out of Hospital Infections’ Clostridium difficile infections and Staphylococcus aureus (including MRSA) bacteraemia cases are all associated with being treated in hospitals. However, this is not the only place a patient may contract an infection. This total will also include infection from community sources such as GP surgeries and care homes and. The final Report Card report in this section covers ‘Out of Hospital Infections’ and reports on SAB and CDI cases reported to a Health Board which are not attributable to a hospital.
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NHS BOARD REPORT CARD – NHS Grampian Staphylococcus aureus bacteraemia monthly case numbers Jun
2014 Jul
2014 Aug 2014
Sept 2014
Oct 2014
Nov 2014
Dec 2014
Jan 2015
Feb 2015
Mar 2015
Apr 2015
May 2015
MRSA 0 3 1 1 2 1 0 1 0 1 1 0 MSSA 8 12 15 16 14 7 15 7 12 7 11 17 Total SABS 8 15 16 17 16 8 15 8 12 8 12 17 Clostridium difficile infection monthly case numbers Jun
2014 Jul
2014 Aug 2014
Sept 2014
Oct 2014
Nov 2014
Dec 2014
Jan 2015
Feb 2015
Mar 2015
Apr 2015
May 2015
Ages 15-64 1 3 3 4 5 3 1 2 2 4 6 5 Ages 65 plus 8 10 11 12 6 7 9 6 3 13 5 5 Ages 15 plus 9 13 14 16 10 10 10 8 5 17 11 10 Hand Hygiene Monitoring Compliance (%) Jun
2014 Jul
2014 Aug 2014
Sept 2014
Oct 2014
Nov 2014
Dec 2014
Jan 2015
Feb 2015
Mar 2015
Apr 2015
May 2015
AHP 99 98 99 98 98 100 100 99 99 99 98 98 Ancillary 98 98 97 95 96 99 96 97 97 97 97 94 Medical 96 96 96 94 93 96 98 97 95 96 95 93 Nurse 99 99 98 98 98 99 99 99 99 99 98 97 Board Total 98 98 98 97 97 98 99 99 98 98 98 96 Cleaning Compliance (%) Jun
2014 Jul
2014 Aug 2014
Sept 2014
Oct 2014
Nov 2014
Dec 2014
Jan 2015
Feb 2015
Mar 2015
Apr 2015
May 2015
Board Total 94 94 94 94 94 94 94 94 95 94 94 94 Estates Monitoring Compliance (%) Jun
2014 Jul
2014 Aug 2014
Sept 2014
Oct 2014
Nov 2014
Dec 2014
Jan 2015
Feb 2015
Mar 2015
Apr 2015
May 2015
Board Total 96 96 96 97 97 96 97 97 97 97 97 97
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NHS HOSPITAL A REPORT CARD – Aberdeen Royal Infirmary Staphylococcus aureus bacteraemia monthly case numbers Jun
2014 Jul
2014 Aug 2014
Sept 2014
Oct 2014
Nov 2014
Dec 2014
Jan 2015
Feb 2015
Mar 2015
Apr 2015
May 2015
MRSA 0 0 0 0 0 1 0 0 0 1 0 0 MSSA 2 2 6 8 3 1 2 1 3 2 2 5 Total SABS 2 2 6 8 3 2 2 1 3 3 2 5 Clostridium difficile infection monthly case numbers Jun
2014 Jul
2014 Aug 2014
Sept 2014
Oct 2014
Nov 2014
Dec 2014
Jan 2015
Feb 2015
Mar 2015
Apr 2015
May 2015
Ages 15-64 0 0 0 2 0 0 1 0 1 1 1 3 Ages 65 plus 3 2 3 3 3 1 3 3 0 4 1 1 Ages 15 plus 3 2 3 5 3 1 4 3 1 5 2 4 Cleaning Compliance (%) Jun
2014 Jul
2014 Aug 2014
Sept 2014
Oct 2014
Nov 2014
Dec 2014
Jan 2015
Feb 2015
Mar 2015
Apr 2015
May 2015
Hospital Total 94 94 94 94 94 94 94 94 94 94 94 94 Estates Monitoring Compliance (%) Jun
2014 Jul
2014 Aug 2014
Sept 2014
Oct 2014
Nov 2014
Dec 2014
Jan 2015
Feb 2015
Mar 2015
Apr 2015
May 2015
Hospital Total 98 98 97 98 98 98 98 98 98 98 97 98
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NHS HOSPITAL B REPORT CARD – Dr Gray’s Hospital Staphylococcus aureus bacteraemia monthly case numbers Jun
2014 Jul
2014 Aug 2014
Sept 2014
Oct 2014
Nov 2014
Dec 2014
Jan 2015
Feb 2015
Mar 2015
Apr 2015
May 2015
MRSA 0 0 0 0 0 0 0 0 0 0 0 0 MSSA 0 0 0 0 0 0 0 0 0 0 0 1 Total SABS 0 0 0 0 0 0 0 0 0 0 0 1 Clostridium difficile infection monthly case numbers Jun
2014 Jul
2014 Aug 2014
Sept 2014
Oct 2014
Nov 2014
Dec 2014
Jan 2015
Feb 2015
Mar 2015
Apr 2015
May 2015
Ages 15-64 0 0 0 0 0 0 0 0 0 0 0 0 Ages 65 plus 0 0 0 0 1 0 1 0 1 0 0 0 Ages 15 plus 0 0 0 0 1 0 1 0 1 0 0 0 Cleaning Compliance (%) Jun
2014 Jul
2014 Aug 2014
Sept 2014
Oct 2014
Nov 2014
Dec 2014
Jan 2015
Feb 2015
Mar 2015
Apr 2015
May 2015
Hospital Total 94 94 93 93 94 94 94 94 95 94 94 94 Estates Monitoring Compliance (%) Jun
2014 Jul
2014 Aug 2014
Sept 2014
Oct 2014
Nov 2014
Dec 2014
Jan 2015
Feb 2015
Mar 2015
Apr 2015
May 2015
Hospital Total 98 98 98 98 98 98 98 98 98 98 97 97
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NHS HOSPITAL B REPORT CARD – Woodend Hospital Staphylococcus aureus bacteraemia monthly case numbers Jun
2014 Jul
2014 Aug 2014
Sept 2014
Oct 2014
Nov 2014
Dec 2014
Jan 2015
Feb 2015
Mar 2015
Apr 2015
May 2015
MRSA 0 0 0 0 0 0 0 0 0 0 0 0 MSSA 0 0 0 0 0 0 0 0 0 0 0 0 Total SABS 0 0 0 0 0 0 0 0 0 0 0 0 Clostridium difficile infection monthly case numbers Jun
2014 Jul
2014 Aug 2014
Sept 2014
Oct 2014
Nov 2014
Dec 2014
Jan 2015
Feb 2015
Mar 2015
Apr 2015
May 2015
Ages 15-64 0 0 0 0 0 0 0 0 0 0 0 0 Ages 65 plus 0 0 0 0 0 1 1 0 0 0 0 0 Ages 15 plus 0 0 0 0 0 1 1 0 0 0 0 0 Cleaning Compliance (%) Jun
2014 Jul
2014 Aug 2014
Sept 2014
Oct 2014
Nov 2014
Dec 2014
Jan 2015
Feb 2015
Mar 2015
Apr 2015
May 2015
Hospital Total 94 93 94 94 94 94 95 96 94 95 94 94 Estates Monitoring Compliance (%)
Jun 2014
Jul 2014
Aug 2014
Sept 2014
Oct 2014
Nov 2014
Dec 2014
Jan 2015
Feb 2015
Mar 2015
Apr 2015
May 2015
Hospital Total 92 91 92 95 96 97 96 98 98 98 97 97
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OTHER NHS HOSPITALS REPORT CARD
The other hospitals covered in this report card include: Aberdeen Maternity Hospital Royal Cornhill Hospital Royal Aberdeen Children's Hospital Roxburgh House All Community Hospitals Staphylococcus aureus bacteraemia monthly case numbers Jun
2014 Jul
2014 Aug 2014
Sept 2014
Oct 2014
Nov 2014
Dec 2014
Jan 2015
Feb 2015
Mar 2015
Apr 2015
May 2015
MRSA 0 0 0 0 2 1 0 0 0 0 0 0 MSSA 0 0 1 0 1 0 3 0 0 0 0 1 Total SABS 0 0 1 0 3 1 3 0 0 0 0 1 Clostridium difficile infection monthly case numbers Jun
2014 Jul
2014 Aug 2014
Sept 2014
Oct 2014
Nov 2014
Dec 2014
Jan 2015
Feb 2015
Mar 2015
Apr 2015
May 2015
Ages 15-64 0 0 0 0 0 2 0 0 0 0 0 0 Ages 65 plus 0 2 3 3 0 0 1 1 0 2 0 1 Ages 15 plus 0 2 3 3 0 2 1 1 0 2 0 1
NHS OUT OF HOSPITAL REPORT CARD Staphylococcus aureus bacteraemia monthly case numbers Jun
2014 Jul
2014 Aug 2014
Sept 2014
Oct 2014
Nov 2014
Dec 2014
Jan 2015
Feb 2015
Mar 2015
Apr 2015
May 2015
MRSA 0 3 1 1 2 0 0 0 0 1 1 0 MSSA 6 10 8 8 10 6 10 6 9 5 9 10 Total SABS 6 13 9 9 12 6 10 6 9 5 10 10 Clostridium difficile infection monthly case numbers Jun
2014 Jul
2014 Aug 2014
Sept 2014
Oct 2014
Nov 2014
Dec 2014
Jan 2015
Feb 2015
Mar 2015
Apr 2015
May 2015
Ages 15-64 1 2 3 2 3 1 0 2 1 3 5 2 Ages 65 plus 5 7 5 6 3 5 3 2 2 7 4 3 Ages 15 plus 6 9 8 8 6 6 3 4 3 10 9 5
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