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Hospitals: Infectious Diseases

Volume 468: debated on Thursday 29 November 2007

To ask the Secretary of State for Health how many cases of (a) methicillin-resistant staphylococcus aureus, (b) vancomycin-intermediate staphylococcus aureus, (c) clostridium difficile- associated diarrhoea, (d) vancomycin-resistant staphylococcus aureus and (e) glycopeptide-resistant enterococci were recorded in each hospital in England in each of the last five years; and if he will make a statement. (163401)

From April 2001 all national health service acute trusts in England were required to report all cases of methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections under the mandatory surveillance scheme run by the Health Protection Agency (HPA). The latest data for each trust for the quarter from April to June 2007 and for each 12 month period from April 2001 to March 2007 are available (table 3 and table 5 respectively) at

Data are not collected for vancomycin-intermediates Staphylococcus aureus or vancomycin-resistant Staphylococcus aureus under the mandatory surveillance scheme. However, the Staphylococcal Reference and Antibiotic Resistance Monitoring Laboratory (ARMRL), the national reference laboratory responsible for the detection and investigation of antibiotic resistance, has screened over 50,000 MRSA isolates for resistance to vancomycin in the past 10 years. Of these, the ARMRL has confirmed two isolates of vancomycin-intermediate Staphylococcus aureus. The ARMRL has not confirmed any isolates of vancomycin-resistant Staphylococcus aureus.

Information is also available by acute NHS trust for England for Clostridium difficile infection under the mandatory surveillance scheme from January 2004 in people aged 65 years and over. The latest data for the first two quarters of 2007 and data for 2004, 2005 and 2006 are available at (table 1 and table 2 respectively)

The HPA also collects acute trust data on Glycopeptide-resistant enterococci blood stream infections in England from October 2003. Data for each 12 month period from October 2003 to September 2006 were published in July 2007 at:

To ask the Secretary of State for Health what assessment he has made of the effect on the level of hospital-acquired infections of the widespread introduction of subcontracting in hospital cleaning; and if he will make a statement. (164412)

Mandatory surveillance of health care associated infections was not introduced until 2001 but prevalence surveys of health care associated infections were undertaken in 1980, 1993 and 2006. There has been little change in the prevalence of hospital acquired infections overall over the last 20 years.

The Conservative Government introduced compulsory competitive tendering in 1983, requiring the national health service to market-test domestic cleaning, catering, and linen and laundry services on a regular basis. This Government lifted that requirement in 2000, and trusts must now benchmark their services before deciding whether to market-test.

Current guidance on contracting for cleaning makes it clear that quality must be considered alongside cost in decisions on how to provide cleaning services. Recent information suggests that there is currently no difference between in-house and outsourced cleaning in terms of standards and outcomes.