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Surveillance updates
CDI Objectives

Clostridioides difficile Infection Objectives

CDI Objectives and assessment tool are available on the NHS Improvement website.

Epidemiology

PHE runs national surveillance programmes to collect data on HCAI. Surveillance programmes cover:

Clostridium difficile

Clostridium difficile (C. difficile) is a bacterium that’s found in people’s intestines. It can be found in healthy people, where it causes no symptoms (up to 3% of adults and 66% of babies).

Escherichia coli

Escherichia coli (E. coli) bacteria are frequently found in the intestines of humans and animals. There are many different types of E. coli, and while some live in the intestine quite harmlessly, others may cause a variety of diseases.

Staphylococcus aureus

Staphylococcus aureus (S. aureus) is a bacterium that commonly colonises human skin and mucosa without causing any problems. It can also cause disease, particularly if there is an opportunity for the bacteria to enter the body, for example through broken skin or a medical procedure.

HCAI Stakeholder Engagement Forum Minutes

The HCAI mandatory surveillance user engagement forum is held on a routine basis throughout the year to ensure that Mandatory HCAI surveillance outputs reflect user need. An invitation is added to the HCAI DCS login page to encourage users to express interest in attending the event via skype meeting.

Stakeholder Engagement Summary

The minutes from the forums are available below.

HCAI Stakeholder Engagement minutes 2019

HCAI Stakeholder Engagement minutes 2018
HCAI Stakeholder Engagement minutes 2017
HCAI Stakeholder Engagement minutes 2016 HCAI Stakeholder Engagement minutes 2015

Management of healthcare associated infections

Management of healthcare associated infections (HCAI)
Preventing and reducing rates of HCAI involves infection prevention and control, using evidence-based interventions.

Surveillance programmes are an important part of this, as they provide essential information on:

 what and where the problems are
 how well control measures are working

Follow this link to view further information

MRSA Whole Genome Sequence (WGS)

Between 1st April 2017 and 31st March 2019, an enhanced MRSA surveillance programme was launched. This involved whole genome sequencing of MRSA isolates of cases reported in England within that period. A "chase for isolate" strategy was used, which involved active requests of the isolates of HCAI DCS MRSA cases which were not sent to PHE for typing. This strategy aimed to improve the isolates collection coverage in England and increase the knowledge on circulating MRSA strains in both hospital and community settings. This surveillance programme provided meaningful information on the distribution of MRSA causing bacteraemia in England. Interim reports have been already been presented at two conferences, ECCMID (2018) and ISSSI (Aug 2018). Future work will focus on national surveillance in response to the increase in MSSA bacteraemia.
Post Infection Review Update

NHS Improvement have updated their guidance on MRSA Post Infection Review (PIR). The updated guidance can be found here.
For MRSA cases with specimen dates from April 2018, the PIR process will no longer be required, but instead replaced by formal local reviews of MRSA cases for those Trusts and CCGs with the highest MRSA rates. The MRSA reviews will also move from being administered through the DCS to a process administered and run locally. From 1st April 2018, MRSA cases with a specimen date of equal to or greater than 1st April 2018 will not trigger a PIR and the associated, question tabs and email notifications. Cases with a specimen date prior to 1st April 2018 will still initiate a PIR even if they are entered on the DCS after 1st April 2018.