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Mandatory Surveillance of Staphylococcus aureus bacteraemia

Please note as of April 2013 Primary Care Organisations (PCOs) ceased to exist and were replaced by Clinical Commissioning Groups (CCGs). Therefore data published monthly is now reported by CCG rather than PCO.

Additionally, all NHS organisations reporting positive cases of MRSA bacteraemia from the 1st April 2013, are required to complete a Post Infection Review (PIR). As a a result, monthly MRSA bacteraemia data will no longer be apportioned and will be published on the basis of relevant PIR assignment (acute Trust or CCG).

Archive monthly outputs reporting data to the end of March 2013 are still presented by PCO and Trust apportionment.

The results of the mandatory MRSA bacteraemia enhanced surveillance scheme:

  • MRSA bacteraemia tables - Monthly: Acute Trust and CCG results by PIR assignment by month for April 2013. All cases by CCG for a 13 month period.
  • MRSA bacteraemia tables - Annual: Acute Trust and Clinical Commissioning Group (CCG) results by quarter and by financial year. April 2007 onwards.
  • MRSA bacteraemia commentaries - Quarterly: Commentary on trends over a period of 9 quarters.

The results of the mandatory MSSA bacteraemia enhanced surveillance:

  • MSSA bacteraemia tables - Monthly: Acute Trust and Clinical Commissioning Group (CCG) results by month for a 13 month period.
  • MSSA bacteraemia tables - Annual: Acute Trust and Clinical Commissioning Group (CCG) results by quarter and by financial year. January 2011 onwards.
  • MSSA bacteraemia commentaries - Quarterly: Commentary on trends over a period of 5 quarters.

Background information

Public Health England- PHE ( formerly the Health Protection Agency) has been managing, on behalf of the Department of Health, the mandatory surveillance of Staphylococcus aureus bacteraemia in England since April 2001.

The following aggregated data ("quarterly lab returns") are also collected as part of this surveillance scheme:

  • Total blood culture sets examined (a sample arising from a single venepuncture, irrespective of the number of bottles tested)
  • Total number of positive blood cultures (all positive results for bacterial growth, including repeat specimens and contaminants)

Positive blood cultures from the same patient within 14 days of the initial culture are considered to be part of the original episode and should not be reported. Duplicate reports, more than 14 days apart should be reported as these are considered to be a separate episode.

Mandatory MRSA and MSSA bacteraemia surveillance scheme

The surveillance of Meticillin-resistant Staphylococcus aureus (MRSA) bacteraemia has been mandatory for all NHS acute trusts in England since April, 2004. In October 2005 this surveillance was enhanced to collect patient-level data. This scheme has been developed by PHE at the request of the Department of Health. In January 2011 this scheme was extended to include surveillance of MSSA bacteraemia.

By comparison to the quarterly laboratory returns, enhanced surveillance involves collecting patient details for each MRSA bacteraemia episode such as NHS number, hospital number, date of birth, and sex, as well as information concerning the patient's location, date of admission, consultant specialty, and care details at the time the blood sample was taken. Trusts have access to a web-based surveillance system, where these details on each MRSA bacteraemia episode can be entered.

PHE produces tables of counts of MRSA bacteraemia and MSSA bacteraemia on a monthly and annual basis. The first annual MSSA bacteraemia data was published July 2012. Every quarter the data collected in the enhanced surveillance is used to produce epidemiological commentaries with the aim of contributing to a better evidence base regarding risk factors for infection.

PHE is committed to continuing to produce data on Official Statistics, for other data outputs please see our HCAI Reporting within Independent Sector Healthcare organisations and Mandatory Surveillance weekly reports.

The future dates for publication of mandatory surveillance data are available via the publication schedule pages.

NHS Acute Trusts can obtain further information about the scheme by emailing mandatory.surveillance@phe.gov.uk.

From 1 April 2013 onwards, all organisations reporting positive MRSA bacteraemia will be required to complete a Post Infection Review (PIR) . Further information and guidance on the PIR process [external link] can be found on the NHS Commissioning Board website. Data will be published on the basis of relevant PIR assignment (acute Trust or CCG).

As of the 31 March 2011 the formal non-trajectory appeals process came to an end. A document entitled Examples of Frequent Non-Trajectory appeals has been put together to assist local commissioners when assessing appeals for MRSA bacteraemia cases.

Information regarding the HCAI stakeholder meeting held in November 2009 is available on the HCAI Mandatory Surveillance Stakeholder Meeting page.