Report names hospitals with highest proportions of deaths related to MRSA and C difficile

Numbers of deaths in English and Welsh hospitals involving meticillin resistant Staphylococcus aureus (MRSA) and Clostridium difficile vary widely, a new report shows. In several hospitals more than 2% of all deaths were linked to C difficile, and in four hospitals more than 1% of all deaths involved MRSA.

Hospitals with a relatively high number of deaths involving MRSA also tended to have a high number of deaths involving C difficile, but the relation was weak, says the report from the Office for National Statistics (ONS).

The report, which shows numbers of deaths by individual establishment, has data for 217 hospitals and one hospice that had a total of more than 2500 deaths from all causes for the two periods looked at, 2001-5 and 2002-6. These establishments account for more than 80% of the total number of deaths involving MRSA and C difficile in England and Wales.

The report says, “There has been a sustained increase in the number of death certificates mentioning MRSA and C difficile in recent years, although deaths involving MRSA levelled off in 2006.

“This has been accompanied by an increased level of interest in these conditions, and rising public demand for information on the number of deaths involving MRSA and C difficile by individual place. Previous ONS reports have published data on deaths involving MRSA and C difficile by establishment type of place of death, but not by individual communal establishment.”

In 2001-5 in the 218 establishments, the total number of deaths involving MRSA was 4293, and that involving C difficile was 8555; in 2002-6 the respective figures were 5109 and 13 189. Overall in these establishments the percentage of deaths involving MRSA rose from 0.33% of all deaths in 2001-5 to 0.39% in 2002-6. The number of deaths involving C difficile rose from 0.66% of all deaths to 1.01%.

No relation was found between the total number of deaths in each hospital and the proportion of deaths involving MRSA or C difficile. “Thus establishments dealing with particularly large numbers of deaths did not necessarily have high proportions involving either MRSA or C difficile,” says the report.

The data for individual hospitals for 2002-6 show that in two hospitals more than 3% of deaths involved C difficile: George Eliot Hospital in Nuneaton, with 3.6% (235 deaths), and Royal United Hospital in Bath, with 3.2% (268). The third highest was Leicester General Hospital, at just under 3% (169), followed by the General Hospital in Kettering, with 2.9% (200). In four hospitals the percentage of all deaths involving MRSA exceeded 1%: Maelor Hospital, Wrexham (1.4% (79 deaths)), Musgrove Park Hospital, Taunton, (1.2% (77)), Royal Sussex County Hospital, Brighton (1.1% (75), and St Mary’s Hospital, Portsmouth (just over 1% (33)).

The ONS says that for a number of reasons the figures in the report should be interpreted with caution. It points out that figures are based on the establishment where deaths occurred, which is not necessarily where an infection was acquired or where any treatment that led to a hospital associated infection was given. Also, it says that death certification practices may vary between areas and that numbers of deaths involving MRSA and C difficile may be higher in establishments with a higher proportion of seriously ill or very old patients.