Health Care Associated Infection

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When a person contracts an infection while receiving medical treatment in a hospital, an outpatient clinic, nursing home or other health care setting, it is known as a Health Care Associated Infection (HCAI). HCAI is not a new and has always been a potential complication of medical treatment. Not all forms of HCAI are due to antibiotic resistant bacteria but some are particularly well known such meticillin-resistant Staphylococcus aureus (MRSA), which accounts for about 10% of HCAI, vancomycin-resistant enterococci (VRE) and extended-spectrum b -lactamase (ESBL) producing Enterobacteriaciae.

There are many reasons why HCAI appears to be now more common, including improved diagnostics, a greater awareness of the quality of care, an increased population of ‘high-risk’ patients and increased resistance to antibiotics. While antibiotics can be used to treat the majority of Healthcare-associated infections, they are less effective against some bacteria such as MRSA, which is a type of Staphlococcus aureus; hence its full name Methicillin Resistant Staphlococcus aureus. MRSA’s resistance to antibiotics is the result of Ireland ’s above EU average level of antibiotic prescribing and pattern of prescribing broad spectrum antibiotics.

The HSE is committed to preventing and controlling HCAI and minimising AMR, by building on pre-existing initiatives (e.g.: the Strategy for the control of Antimicrobial Resistance in Ireland (SARI) and utilising the expertise and commitment of all healthcare workers throughout the health service. The HSE is also availing of the assistance and co-operation of the public, in improving the quality of patient care.

Although it is acknowledged that we have sub-optimal information on the extent and range of HCAI in Ireland due to inadequate surveillance systems, the setting of targets represents a commitment to improving the quality of care for all Irish patients. The HSE targets in the area of HCAI are: