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Hospital Performance: Healthcare-associated Staphylococcus aureus bloodstream infections in 2011–12

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Media backgrounder, November 2013
EMBARGOED TO 1AM, THURSDAY 23 MAY 2013

Preventable bloodstream infections highest at major hospitals

Background information

Hospital Performance: Healthcare-associated Staphylococcus aureus bloodstream infections in 2011–12 looks at the rate of bloodstream infections caused by one type of bacteria, Staphylococcus aureus (S. aureus), that patients develop during the course of medical treatment or care provided by hospitals. S. aureus is sometimes referred to as ‘Golden Staph’.

How common is S. aureus in hospitals?

The annual number of healthcare-associated S. aureus bloodstream infections is small compared to the total number of patients that pass through Australia’s public hospitals each year. On pages 7 to 10 of the main report are figures showing the rate of healthcare-associated S. aureus bloodstream infections in public hospitals. Across 352 hospitals, 1,725 cases were recorded in 2011–12.

However, every case of healthcare-associated S. aureus bloodstream infection is considered potentially preventable, so there has been an increasing focus on monitoring its impact and introducing strategies to combat it.

How serious are these infections?

Patients with healthcare-associated S. aureus bloodstream infections can become very ill and have longer stays in hospital. Such infections can be very serious. Evidence suggests between 20% to 35% of people who experience S. aureus bloodstream infections die from this or a related cause.

What are the eight peer groups?

To allow fairer comparisons, the Authority has allocated hospitals to one of eight groups based on a combination of size of hospital, type of services provided and the percentage of patients at-risk of healthcare-associated infections.

Why haven’t you named hospitals across all eight peer groups?

The Authority has named hospitals with the highest and lowest rates of healthcare-associated S. aureus bloodstream infections in the two major hospital peer groups, as this is where most cases occur.

Hospitals in the other peer groups have not been named for a number of reasons. In smaller facilities, a single extra case can be enough to cause a marked increase in the annual rate for a hospital, while zero rates reported by some hospitals could reflect immature data collection systems rather than zero infections.

What is an ‘at-risk’ patient?

For this report patients are considered ‘at-risk’ or ‘vulnerable’ if they have one or more of the following risk factors:

1. Immunosuppressed patients. Such as patients admitted for:

  • Bone marrow transplant
  • Burns
  • Disorders of the immune system
  • HIV/AIDS
  • Oncology and malignancies of the blood such as leukaemia and lymphoma
  • Transplant

and

2. Opportunities for infection. Such as patients admitted for:

  • Acute renal failure
  • Acute spinal injury
  • Surgery (including cardiac)
  • Venous catheterisation.

What does the phrase “immature” information systems mean?

While the national definition for healthcare-associated S. aureus bloodstream infection was endorsed by states and territories in 2009, the definition for national submission of data has evolved and changed more than once since then to allow it to be used for public reporting.

Information reviewed by the Authority for this report demonstrated some differences in how states and hospitals measure and record cases and patient bed days. This suggests information systems are still developing and is it is too early to expect national consistency in comparing hospitals across Australia.

Could there be more cases of S. aureus in hospitals?

The figures across all peer groups in the report reflect confirmed cases of healthcare-associated S. aureus bloodstream infections. Other cases that were not confirmed or reported - for example, because tests were not done, or because test results were not properly recorded - could comprise extra cases not currently included in the results. The Authority is aware of these limitations of the data and is undertaking work to improve future reporting on the comparable performance of health care organisations.

Why did you report on only some public hospitals?

This report is based on data from 352 hospitals across Australia that monitored healthcare-associated S. aureus bloodstream infections and had more than 5,000 patient bed days monitored. These 352 hospitals accounted for more than 97% of all monitored bed-days in 2011–12 and more than 99% (1725 of 1734) of all reported cases of healthcare-associated S. aureus bloodstream infections.