Recent data published by the Health Protection Agency (HPA) show that each year in England around 7000 inpatients have methicillin resistant Staphylococcus aureus (MRSA) bacteraemia and more than 50 000 inpatients aged 65 years and over have Clostridium difficile infections.1C difficile cases rose by 5.5% in 2006 compared with 2005, whereas MRSA cases fell by 4.3% over a similar period. HPA spokespeople said they thought that the rate of increase of C difficile was slowing and MRSA rates had reached a plateau.

My own time series analyses of the reported data failed to detect any significant change in rates of C difficile or MRSA, though C difficile increases significantly during winter (www.geriatric.med.ed.ac.uk/john_starr.htm). The seasonal variation may be a result of many older people who require antibiotic treatment being admitted to hospital at that time of year. Despite the HPA data, there is a consensus that hospital acquired infection rates remain high and that recent control measures are having only a …