Kidney services remain in the “MRSA spotlight”. The first quarterly mandatory enhanced staphlococcal surveillance reporting to include the renal data subset – containing information on dialysis modality and access type – were published on 1 November 2007. The results are mixed. One of the problems is sharing the MESS record between the mico-biology department and kidney services. All in all data returns were disappointing, with a low completion rate of the renal additional renal information. Some of this in undoubtedly due to system issues, such as duplicates, lack of correct assignment or the incorrect contact details in the main unit, but the renal community do need to help. It is the first quarter that the system has been operating so 46% completion must be seen in that light but there is no room for complacency when it comes to data quality. However, there are reasons for cautious optimism regarding the national picture with the proportion of MRSA bloodstream infections related to renal patients falling by a quarter from 8% (2006) to 6% (2007) of the total MRSA bloodstream infections reported in England.
Those headline results of course hide the local picture. Some units have achieved and maintained dramatic reductions, a few units never had a problem and worryingly, despite ostensibly good efforts, several units show a deteriorating picture. The numbers are so small that statistical comparison is inappropriate but the patients affect and our CEO colleagues will have noticed!!
If you have any difficulty with the MESS system do contact Richard Fluck on Richard.fluck@nhs.net or 01332 789344 (direct line) or for more information on the Renal MRSA action plan and how you can apply that locally contact Mercia Spare on Mercia.Spare@dh.gsi.gov.uk or 020 797 7396.
The Health Projection Agency's (HPA) latest MRSA bacteraemia results; reports and individual Trust listings are available here.
