HPA Published Study Of Deaths Following MRSA infection
New research published today by the Health Protection Agency and the Office for National Statistics has found that the majority of patients dying following MRSA infection had significant underlying chronic medical conditions and had short life expectancies, irrespective of their MRSA infection.
The two year confidential study, commissioned by the Department of Health , reviewed a small randomly selected sample of patients in two phases. The first phase reviewed 18 cases known to have MRSA documented on their death certificate and the second phase 38 patients who had died within 30 days of an MRSA bloodstream infection, identified through the linkage of data on infection held by the Agency to mortality data held by the ONS.
Using information from patient records and interviews with healthcare staff, an expert panel attempted to identify for each patient where they acquired their infection; the source of the infection; if the patient was suffering from any underlying conditions that may have left them prone to infection; how well their care was managed, and what factors caused or contributed to their death.
Of the 38 main phase cases, on review of available evidence the expert panel found that MRSA was the main or contributing cause of death in 22 cases. The expert panel found that MRSA had not contributed to the deaths of 9 of the 18 pilot cases. Ongoing work, as part of this study, will be looking in more detail at the completeness of reporting of MRSA on death certification following MRSA infection.
The study also found that the most frequently identified source of MRSA infection in patients who developed blood poisoning was via invasive devices, particularly intravenous (IV) drips and/or catheters. However, not all of the 18 Trusts were auditing compliance with policies regarding invasive procedures, and there were inconsistencies with the recording of invasive devices in patient records.
The study also highlighted that national screening policies were not always followed by the Trusts taking part in the study, with s ome Trusts citing problems with implementation due to the lack of isolation rooms available to them.
Dr Georgia Duckworth, the principal investigator for the study at the Agency said, " The findings of this small qualitative study cannot be extended to all Trusts in England , but it did bring to light certain shortcomings in the overall management of MRSA infection, although these were not considered to have affected the outcome in the cases investigated.
"It does identify some areas where procedures should be more rigorous, such as the management of IV drips and compliance with MRSA screening policies
"This study highlights several areas of patient care requiring further attention from clinicians and policymakers to minimise the likelihood of patients acquiring an MRSA infection or subsequently dying as a result of the infection. "