Search control section

Hospital Performance: Healthcare-associated Staphylococcus aureus bloodstream infections in 2013–14, In Focus

Left hand navigation section

Download Report (PDF, 3.4 MB)

Key findings

In 2013–14, 1,448 cases of healthcare-associated S. aureus bloodstream infection were reported by the 115 major and large public hospitals covered in this report. This represents nearly 90% of the 1,621 cases of this infection reported by public hospitals nationally.

Results by hospital peer group

Major hospitals reported a disproportionate share of healthcare-associated S. aureus bloodstream infections. These hospitals accounted for 81% of all reported and 64% of all patient bed days monitored.

  • At the 36 major hospitals with more vulnerable patients, there were 972 cases of S. aureus bloodstream infection. The average rate of infection was 1.28 per 10,000 patient bed days.
  • At the 40 major hospitals with fewer vulnerable patients, there were 338 cases of S. aureus bloodstream infection. The average rate of infection was 0.78 per 10,000 patient bed days.

Large hospitals accounted for about 9% of all reported cases and 11% of all patient bed days monitored.

  • At the 16 large hospitals with more vulnerable patients, there were 87 cases of S. aureus bloodstream infection. The average rate of infection was 1.15 per 10,000 patient bed days.
  • At the 23 large hospitals with fewer vulnerable patients, there were 51 cases of S. aureus bloodstream infection. The average rate of infection was 0.42 per 10,000 patient bed days.

Variation in infection rates and counts across similar hospitals

All major hospitals, except for one, reported at least one case of healthcare-associated S. aureus bloodstream infection.

  • At major hospitals with more vulnerable patients the rate of infection was more than three times higher at some hospitals than others (range: 0.59 to 2.32 per 10,000 patient bed days).
  • At major hospitals with fewer vulnerable patients the rate of infection showed a similar level of variation to other major hospitals (range: 0 to 1.67 per 10,000 patient bed days).

Among large hospitals, 33 of the 39 hospitals reported at least one case of healthcare-associated S. aureus bloodstream infection.

  • At large hospitals with more vulnerable patients the rate of infection ranged from 0 to 2.48 per 10,000 patient bed days.
  • At large hospitals with fewer vulnerable patients, the rate of infection ranged from 0 to 0.97 per 10,000 patient bed days.

Fair comparison

To allow fairer comparisons, the Authority has allocated hospitals to one of four peer groups based on a combination of hospital size, type of services provided and the percentage of patients more at risk of acquiring a healthcare-associated infection. Hospitals with more vulnerable patients have a higher percentage of patients admitted for the treatment of conditions such as cancer, HIV/AIDS, burns or surgery than other hospitals.

There are uncertainties about the completeness and national consistency of the data across all hospitals. This means that results could be affected by some degree of under-reporting.

Higher rates cannot definitively indicate that patients at those hospitals are at greater risk of harm compared to patients at other hospitals. High values are however a cause for further investigation.

Table 1: Healthcare-associated S. aureus bloodstream infections in major and large public hospitals, by reported cases and rate per 10,000 patient bed days, 2013–14

Major hospitals

Major hospitals, more vulnerable patients*

Total number of hospitals in peer group 36
All cases reported nationally (%) 60%
All patient bed days monitored (%) 41%
State Hospital Cases Rate
NSW St Vincent’s 32 2.32
John Hunter 43 1.61
Westmead 47 1.49
St George 31 1.44
Gosford 25 1.42
Prince of Wales 26 1.39
Nepean 26 1.30
Liverpool 37 1.26
Royal North Shore 29 1.23
Royal Prince Alfred 34 1.18
Wollongong 11 0.59
Vic Monash [Clayton] 39 1.65
St Vincent’s 26 1.47
Royal Melbourne 31 1.35
Ballarat 12 1.35
Western 17 1.31
Austin 29 1.25
The Alfred 27 1.13
Dandenong 16 0.86
The Northern 12 0.80
Box Hill 11 0.73
Geelong 12 0.66
Qld Royal Brisbane & Women’s 72 2.18
Townsville 40 1.98
Princess Alexandra 36 1.20
Mater Adult 6 1.13
Prince Charles 14 0.75
WA Royal Perth 58 1.90
Sir Charles Gairdner 41 1.70
Fremantle 17 0.83
SA Royal Adelaide 27 0.93
Queen Elizabeth 10 0.70
Flinders 16 0.66
Tas Royal Hobart 14 0.90
ACT Canberra 26 1.05
NT Royal Darwin 22 1.23
Peer result 972 1.28

Major hospitals, fewer vulnerable patients*

Total number of hospitals in peer group 40
All cases reported nationally (%) 21%
All patient bed days monitored (%) 23%
State Hospital Cases Rate
NSW Port Macquarie 10 1.33
Dubbo 7 1.30
Blacktown 16 1.28
Concord 26 1.22
Lismore 11 1.19
Bankstown 14 0.89
Campbelltown 13 0.89
Wyong 9 0.82
Sutherland 9 0.80
Manning 4 0.79
Wagga Wagga 7 0.77
Shoalhaven 4 0.73
The Tweed 5 0.56
Coffs Harbour 5 0.52
Tamworth 3 0.38
Orange 1 0.09
Vic Frankston 25 1.67
Bendigo 9 0.98
Goulburn Valley [Shepparton] 5 0.66
Maroondah 7 0.64
Casey 5 0.62
Sunshine 5 0.33
Latrobe Regional [Traralgon] 3 0.32
South West [Warrnambool] 0 0.00
Qld Bundaberg 7 0.98
Toowoomba 10 0.94
Rockhampton 7 0.87
Nambour 13 0.84
Ipswich 8 0.71
Logan 8 0.70
Redcliffe 7 0.70
Cairns 11 0.65
Gold Coast 18 0.55
Mackay 3 0.44
Caboolture 2 0.26
WA South West [Bunbury] 3 0.61
SA Lyell McEwin 11 0.74
Tas Launceston 13 1.09
ACT Calvary Public 3 0.33
NT Alice Springs 11 1.08
Peer result 338 0.78

Large hospitals

Large hospitals, more vulnerable patients*

Total number of hospitals in peer group 16
All cases reported nationally (%) 5%
All patient bed days monitored (%) 4%
State Hospital Cases Rate
NSW Calvary Mater [Newcastle] 15 2.48
Albury 8 1.82
Maitland 10 1.52
Ryde 6 1.21
Canterbury 1 0.17
Vic Peter MacCallum 11 2.30
Wimmera [Horsham] 3 1.23
Mildura 6 1.21
Monash [Moorabbin] 4 1.00
Northeast Health [Wangaratta] 4 0.90
West Gippsland [Warragul] 1 0.34
Victorian Eye & Ear 0 0.00
Qld Hervey Bay 8 1.56
Queen Elizabeth II 2 0.32
SA Modbury 2 0.28
Tas North West Regional [Burnie] 6 1.65
Peer result 87 1.15

Large hospitals, fewer vulnerable patients*

Total number of hospitals in peer group 23
All cases reported nationally (%) 3%
All patient bed days monitored (%) 7%
State Hospital Cases Rate
NSW Bathurst 3 0.85
Hornsby 3 0.36
Shellharbour 2 0.33
Grafton 1 0.29
Auburn 1 0.22
Fairfield 1 0.13
Manly 0 0.00
Mona Vale 0 0.00
Goulburn 0 0.00
Vic Angliss 5 0.78
Wodonga 4 0.78
Central Gippsland [Sale] 2 0.66
Werribee Mercy Public 4 0.56
Sandringham 1 0.37
Qld Redland 3 0.51
Mount Isa 0 0.00
WA Rockingham 6 0.97
Geraldton 2 0.62
Armadale-Kelmscott 4 0.49
Kalgoorlie 1 0.37
Albany 1 0.26
Swan District 0 0.00
SA Repatriation General 7 0.67
Peer result 51 0.42
*
More and fewer vulnerable patients refers to hospitals deemed to have, for their peer group, a high or low percentage of patient bed days under surveillance attributable to patients with one or more of the identified risk factors. Risk factors were not weighted to account for differences in the degree to which each factor contributes to risk of S. aureus infection. For more information on measures and peer groups, see the Technical Note.
Albury hospital is located in NSW but is managed by Victoria.
The percentage of vulnerable patients at this hospital was much higher than other hospitals in this peer group; this was due to the high percentage of cancer patients at Peter MacCallum.
Note:
The government-agreed target calls for a rate of no more than 2.0 healthcare-associated S. aureus bloodstream infections per 10,000 patient bed days for each state and territory.
Sources:
National Health Performance Authority analysis of Australian Institute of Health and Welfare, National Staphylococcus aureus Bacteraemia Data Collection 2013–14, data extracted 24 December 2014 and Australian Institute of Health and Welfare, Admitted Patient Care National Minimum Dataset 2011–12, data extracted 26 March 2012.

About the data

Cases of healthcare-associated S. aureus bloodstream infection are identified when a medical professional notices the symptoms and orders a blood test. If this blood test identifies a bloodstream infection by S. aureus, the infection control officer for the hospital is notified. These experts judge if the infection is healthcare-associated and if it is attributable to a hospital. Many steps are necessary for a case of healthcare-associated S. aureus bloodstream infection to be recorded. Failure of any of these steps can interrupt this sequence and lead to under-reporting of this infection.

Figure 1: Healthcare-associated S. aureus bloodstream infections in public healthcare-associated, by major and large healthcare-associated, 2013–14

Image of chart showing the health-care associated S. aureus bloodstream infections in public hospitals, by major and large hospitals for 2013-14

Peer Group Hospital Cases Rate per 10,000 bed days
Major hospitals, more vulnerable patients*
St Vincents NSW 32 2.38
Royal Brisbane & Women’s Qld 72 2.23
The Townsville Hospital Qld 40 2.02
Flinders SA 16 0.67
Geelong Vic 12 0.67
Wollongong NSW 11 0.62
Major hospitals, fewer vulnerable patients*
Frankston Vic 25 1.72
Port Macquarie NSW 10 1.33
Dubbo NSW 7 1.39
Latrobe Regional Vic 3 0.33
Caboolture Qld 2 0.27
Orange NSW 1 0.10
Performance

Named hospitals were in the highest or lowest 10% of results for major hospitals. Major hospitals account for 81% of all reported cases.

Number of cases

Each dot represents a hospital. The size of the dot represents the number of S. aureus cases at that hospital.

The government-agreed target calls for a rate of no more than 2.0 healthcare-associated S. aureus bloodstream infections per 10,000 patient bed days for each state and territory.

*
More and fewer vulnerable patients refers to hospitals deemed to have, for their peer group, a high or low percentage of patient bed days under surveillance attributable to patients with one or more of the identified risk factors. Risk factors were not weighted to account for differences in the degree to which each factor contributes to risk of S. aureus infection. For more information on measures and peer groups, see the Technical Note.
Sources:
National Health Performance Authority analysis of Australian Institute of Health and Welfare, National Staphylococcus aureus Bacteraemia Data Collection 2013–14, data extracted 24 December 2014 and Australian Institute of Health and Welfare, Admitted Patient Care National Minimum Dataset 2011–12, data extracted 26 March 2012.
Download Report (PDF, 3.4 MB)