Many hospital bugs neglected by MRSA targets
Pneumonia and urinary tract infections are among those which deserve more attention, its report said.
The Care Quality Commission said they would “keep up the pressure” on trusts.
Two previous reports from the NAO have played a big role in highlighting the problem of healthcare-associated infections in the NHS.
It led to targets to reduce rates of MRSA and C. difficile – a pressure which has successfully cut those infections.
But they account for only a small proportion of the one in 12 patients admitted to hospital who end up with an infection they did not have before.
Urinary tract infections, largely associated with the use of catheters, are responsible for 20% of these.
Other bloodstream infections with bacteria such as E. coli are also important, the NAO said, and limited data suggests they are on the rise.
Compulsory monitoring of healthcare-associated infections should be widened to cover far more infections and checks should be done to ensure that antibiotics are being used effectively, it concluded.
Karen Taylor, report author, said MRSA and C. difficile rates started to come down only once targets were imposed, although local goals may be more appropriate for other infections.
“It’s looking better for MRSA and C. difficile, which have been subject to targets, but the main focus of our report is they only account for about 15% of healthcare associated infections in hospitals and in the rest of the infections there’s very poor data.
“Some of the bloodstream infections are just as significant on the impact on the patient.”
The report also found that government funding for tackling infections had saved the NHS money overall.
It added that the controversial “deep clean” programme had boosted staff and patient confidence – but it was impossible to measure what effect it had had on the number of infections as other strategies were being implemented at the same time.
HOSPITAL INFECTION BREAKDOWN
Urinary tract infections – 20%
Lower respiratory tract infections – 20%
Gastrointestinal infections – 22%
Surgical site infections – 14%
Bloodstream infections – 7%
Skin and soft tissue infections – 10%
However, even with MRSA and C. difficile there was variation, with 12% of trusts reporting an MRSA infection.
Amyas Morse, head of the NAO, said that in 2004 the problem with MRSA and C. difficile had seemed to be “an intractable problem” and hitting the targets was a “significant achievement”.
“Inevitably, with a focused and centrally driven initiative of this kind, the improvements are not uniform across the NHS and we still don’t know in any meaningful way what impact there has been on other healthcare-associated infections.”
Health minister Ann Keen said: “We remain totally committed to eliminating all preventable healthcare-associated infections.
“As a nurse myself, I am especially pleased to see that the National Audit Office has recognised the contribution that nurses and the reintroduction of matrons onto our wards have had in delivering the reductions in MRSA and C. difficile infections.”