MRSA Action UK: High numbers of C.Diff and MRSA deaths will continue

Friday, 29, Aug 2008 12:00

MRSA Action UK believe deaths from C.difficile may rise still further from the analysis of the Health Protection agency figures published last month. The analysis shows quite clearly that the fight against this particular bacterium is far from being won.

Comparing the January to March quarter of 2006 to January to March 2008 shows 31 Hospital Trusts having more cases of C.difficile over the last 2 years. Our findings make nonsense of the Government’s comments that we have started to make inroads in controlling C.difficile in our Hospitals. The 31 Hospital Trusts in question have increases in C.difficile ranging from 8% to a staggering 400% when compared to the same quarterly figures of 2 years ago. The average increase for these 31 Hospital Trusts alone stands at 44.7%.

Many other Trusts have made very little impact on reducing the incidence of C.difficile and only a small percentage have made significant reductions. Further analysis shows C.difficile are no longer confined to the hospital environment, and that we are beginning to see outbreaks in the community.

This is a shocking toll reported by the ONS, and the comment that this could be due to more complete reporting is questionable. The recording on death certificates of healthcare infections has been called into question not only by patient groups but also by the Department of Health, and our analysis suggests unnecessary premature deaths will continue until these infections are brought under control.

Questions over death certificate documentation remain. Whilst the trend in deaths from MRSA appears to be turning around, a study published by the Health Protection Agency proves these figures are inaccurate, there may even be evidence to suggest these could be at least double due to the anomalies found. The Office for National Statistics can only publish what has been recorded, and MRSA Action UK know only too well, from those of us who have lost family members, the abject failure to recognise healthcare infections where they have either caused or played a significant part in the end of patients’ lives, and, in the most reprehensible circumstances where this could have been avoided.

MRSA Action UK believe the graph showing the downward trend for deaths from MRSA is window dressing as we know the recording is inaccurate.

The National Confidential Study of Deaths Following MRSA Infection carried out in 2007 highlights inconsistencies in the documentation of MRSA on death certificates. A small proportion of documentation assessed were not thought to be related to MRSA infection and should not have had MRSA documented on their death certificate. Conversely where cases were sampled from patients with MRSA bacteraemia who subsequently died, neither MRSA nor sepsis was mentioned on nearly half of the death certificates where MRSA was considered to have caused or contributed to the patient’s death.

The study, published by the Health Protection Agency and funded by the Department of Health, proves that death certificates do not accurately reflect the contribution of MRSA and other infections to the patient’s death and highlight the problems of using death certificates as a source of data on deaths caused by MRSA.

Patients who die with or from MRSA infection often have complex medical histories, this and the tendency for certification to be undertaken by junior medical staff with minimal training, contribute to the poor level of accuracy.

Training for medical staff regarding the completion of death certification using the 2005 guidance from the Office for National Statistics’ Death Certification Advisory Group, should be supported by the auditing of death certificates within Trusts, we believe a significant role for the new Care Quality Commission.

Until accurate recording takes place the Government will never be able to tell us the true scale of the problem, of course the victims and their families will. The Department of Health study was funded from the public purse, yet we see no evidence to suggest action has been taken to provide a more open, honest and accountable way of reporting death attributable to healthcare infections, so that we can feel safe in the knowledge that there truly is every effort being made to save lives in all of our healthcare settings.

With the terrible toll to healthcare infections the Government must not become complacent, deaths from healthcare infections continue to rise and this is wholly unacceptable in an advanced nation in the 21st century.

As this Government fails to acknowledge the scale of the problem we are seeing these bacteria become stronger and stronger leaving future generations a much tougher battle to fight to control them. The indifference to wanting to identify the true death toll to healthcare infections is comparable to Nero fiddling whilst Rome burned. This Government are no different, watching people suffer and die whilst they play the fiddle with the figures on MRSA and C.difficile.

Derek Butler

Chair

MRSA Action UK

http://mrsaactionuk.net

07762 741114