Research shows 80% drop in ICU bloodstream infections
Author: Jo Carlowe
Bloodstream infections acquired in UK Intensive Care Units (ICUs) have dropped by 80% new research* shows.
The findings are based on data collected from over one million patients admitted to 276 NHS adult ICUs across England, Wales and Northern Ireland.
The research was a collaboration between clinicians at Guy's and St Thomas' Biomedical Research Centre and researchers from the Intensive Care National Audit & Research Centre (ICNARC). They found that bloodstream infections overall fell by 80% from 7.3 per 1000 patient days in 2007 to 1.6 per 1000 patient days by 2012.
Published in the journal Clinical Infectious Diseases, the research aimed to measure rates of bloodstream infection after the launch of the national infection control campaign on ICUs and across the NHS. It showed reductions in infections caused by all major organisms including MRSA (95%), Candida (72%) and E. coli (57%).
Dr Jonathan Edgeworth, clinical lead of the Guy's and St Thomas' ICU Infection Service and King's College London professor of clinical infectious diseases said: "The size of this reduction in many of the most serious ICU-acquired infections was frankly unexpected, particularly given that the national focus during that time was recording reductions in MRSA and C. difficile. It implies that improvements in infection control practice were effectively implemented across the board by all members of the ICU team.
"It is notable these lower infection rates have been maintained since 2012 but we need to see if they can be reduced further. The NHS has set new targets for reducing Gram negative bloodstream infection, particularly E. coli, and so this data collection will help monitor progress and also act as an early warning for emergence of new ICU infections.”
Professor David Harrison, head statistician, ICNARC, said: "We collect data on all patients admitted to ICU that are then fed back to individual ICUs for their audit purposes. We also use these data for research to track changes and improve practice. This is a great example of how our data coordinators and statisticians working with front-line clinicians and NHS data collectors, can provide powerful data for the NHS to help it track progress and inform plans for the future.”
He added: "This infection dataset is probably unique in the world given its coverage of the whole national intensive care unit network and having 13 years of continuously collected data. It is one of the advantages of a National Health Service that helps engagement from all ICUs and embedding common clinical practice and infection prevention activities throughout the country.”
*Edgeworth JD, Batra R, Wulff J, et al. Reductions in methicillin-resistant Staphylococcus aureus, C. difficile infection and intensive care unit acquired bloodstream infection across the United Kingdom following implementation of a national infection control campaign. Clinical Infectious Diseases, DOI:10.1093/cid/ciz720