Healthcare-associated infections (HAIs), also known as nosocomial infections, are a significant public health concern and a frequent complication of medical care worldwide. These infections encompass a wide range of illnesses that patients acquire while receiving medical treatment or residing in healthcare facilities, such as hospitals, nursing homes, and outpatient clinics. HAIs can result from a variety of causes, including exposure to bacteria, viruses, fungi, or other pathogens during medical procedures, surgery, or even routine healthcare interactions.
Escherichia coli (E. coli)
Increasing: The number of E. coli cases showed an increasing trend from 2012/13 to 2018/19, with a peak of 43,265 cases in 2018/19.
Decreasing: After 2018/19, there was a decrease in E. coli cases. In 2020/21 and 2021/22, the numbers dropped to 36,801 and 37,965, respectively.
Reason for Changes: The increase in E. coli cases up to 2018/19 may be attributed to various factors, including changes in healthcare practices, population growth, or increased reporting. The subsequent decrease could be influenced by improved infection control measures, public health campaigns, or other interventions.
Klebsiella
Increasing: Cases of Klebsiella, particularly K. pneumoniae, increased from 2017/18 to 2019/20.
Decreasing: In 2020/21 and 2021/22, the number of Klebsiella cases decreased.
Reason for Changes: The increase in Klebsiella cases could be linked to changes in healthcare practices, antibiotic resistance, or better surveillance. The subsequent decrease might be attributed to efforts to control and manage Klebsiella infections.
Pseudomonas aeruginosa
Pseudomonas aeruginosa is a bacterium that can cause infections, including HAIs.It is often associated with healthcare-associated pneumonia, urinary tract infections, and bloodstream infections.
Stable: The number of P. aeruginosa cases remained relatively stable, with around 4,300 cases reported annually throughout the period.
Reason for Stability: The stability in P. aeruginosa cases suggests that current infection control measures and treatment strategies have been effective in maintaining consistent prevalence.
Staphylococcus
Both Methicillin-resistant Staphylococcus aureus (MRSA) and Methicillin-sensitive Staphylococcus aureus (MSSA) are examples of HAIs.These are bacterial infections that can be acquired in healthcare settings, including hospitals. MRSA is particularly problematic due to its antibiotic resistance.
Increasing: Both Methicillin-resistant Staphylococcus aureus (MRSA) and Methicillin-sensitive Staphylococcus aureus (MSSA) cases have significantly increased over the years.
Reason for Changes: A large increase in hospital-onset and intensive care unit-onset Staphylococcus aureus bacteraemia rates in English acute trusts was observed between 2020-2021, coinciding with reported increases in coronavirus disease (COVID-19) cases and associated hospitalisations. Many of these S. aureus bacteraemia cases were defined as co-/secondary infections to COVID-19. Over the same period, increases in the percentage of ventilator associated pneumonia-related bacteraemia were also found. The COVID-19 pandemic appears to have contributed to the increase in hospital-onset S. aureus bacteraemia in England.
Clostridioides difficile
C. difficile infection is another example of a hospital-acquired infection.It is a bacterial infection that is often associated with the use of antibiotics in healthcare settings.
Decreasing: The number of C. difficile cases exhibited a substantial decline over the years.
Reason for Changes: The decline in C. difficile cases can be attributed to improved infection control measures, reduced unnecessary antibiotic use, and increased awareness of the importance of hygiene in healthcare settings.
E. coli and Klebsiella cases experienced fluctuations over the years, with E. coli increasing initially and then decreasing, while Klebsiella cases increased until 2019/20 and decreased afterwards. Pseudomonas aeruginosa remained relatively stable. Both MRSA and MSSA cases however increased, and C. difficile cases showed a substantial decline. These changes are likely due to a combination of improved infection control practices, changes in healthcare procedures, antibiotic stewardship, and public health initiatives to combat these bacterial infections.
Reference
- Clostridioides difficile (C. difficile) infection: annual data. (2023, October 6). GOV.UK. https://www.gov.uk/government/statistics/clostridium-difficile-infection-annual-data
- Escherichia coli bacteraemia: annual data. (2023, October 6). GOV.UK. https://www.gov.uk/government/statistics/escherichia-coli-e-coli-bacteraemia-annual-data
- MRSA, MSSA and Gram-negative bacteraemia and CDI: annual report. (2023, September 28). GOV.UK. https://www.gov.uk/government/statistics/mrsa-mssa-and-e-coli-bacteraemia-and-c-difficile-infection-annual-epidemiological-commentary
