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Not so golden times for staph

Patients at some major metropolitan hospitals are up to three times more likely to contract the potentially deadly Golden Staph bloodstream infection than those being treated at similar institutions with better infection control systems.

While the number of hospital patients catching Golden Staph (Staphylococcus aureus) in the course of their treatment has fallen nationwide, dropping from 1721 cases in 2012-13 to 1621 last financial year – a 6 per cent improvement – analysis by the National Health Performance Authority has found a wide variation in rates of infection between comparable hospitals.

Unsurprisingly, the vast majority of infections (1310) occurred in the nation’s major hospitals, and almost three-quarters (972) involved hospitals treating a relatively high proportion of patients considered vulnerable to contracting the disease.

But the ability of hospitals to curb spread of the disease varied greatly.

The NHPA reported that the rate of Golden Staph infection among major hospitals with more vulnerable patients ranged from 0.59 cases per 10,000 patient bed days at Wollongong Hospital to 2.32 at Sydney’s St Vincent’s Hospital. The average rate among such institutions was 1.28 in 2013-14.

There was a similar discrepancy among large hospitals with more vulnerable patients, from zero cases per 10,000 patient bed days at the Victorian Eye & Ear Hospital to 2.48 at Newcastle’s Calvary Mater Hospital. The average rate was 1.15.

The findings have underlined calls for renewed emphasis on the importance of infection control measures in the nation’s hospitals, particularly those with above-average rates of infection.

The Authority’s Chief Executive Officer Dr Diane Watson said the public reporting of infection rates meant hospitals that were similar in size and function could measure how they were performing relative to their peers, spurring them to address any shortcomings.

“Differences in the rate of infection suggest there is an opportunity for hospitals to continue to learn from each other to lower infection rates,” Dr Watson said.

While the number of Golden Staph infections is declining, it remains a significant killer. Between 20 and 35 per cent of patients who contract the disease in their bloodstream die from this or a related cause, while most of the remainder face a prolonged stay in hospital.

The risk is heightened by the spread of antibiotic-resistant strains of the bug, particularly methicillin-resistant Staphylococcus aureus (MRSA).

Australian National University infectious diseases expert Associate Professor Peter Collignon told the ABC the NHPA report showed there was significant scope for improvement in the infection control procedures of many hospitals.

“What it does show is that when you look at hospitals in the same groups, there are quite wide variations and to me that means that we can do better than what we are doing now,” A/Professor Collignon said, emphasising the importance of regular hand washing and tighter procedures around the use of intravenous lines.

Sydney’s St Vincent’s Hospital, shown to have the second-highest Golden Staph infection rate among the country’s major and large hospitals, said that since then it had completely overhauled its infection control procedures.

Chief executive Associate Professor Anthony Schembri told the ABC that between July last year and March this year its infection rate had virtually halved to 1.3 cases per 10,000 bed days thanks to changed protocols around central and peripheral intravenous line use, upgraded aseptic techniques and surgical site infection prevention.

A/Professor Schembri added the hospital had also launched a major campaign on hand hygiene.

A/Professor Collignon said the long-term decline in Golden Staph infection rates underlined the importance and effectiveness of hand washing and other infection control measures.

Adrian Rollins