Worst' hospital disputes MRSA infection figures

A foundation trust which topped the league table for rates of MRSA infection has attacked the figures as "misleading" claiming they "grossly misrepresent" the hospital's infection control record.

Specialist hospital Queen Victoria hospital NHS trust in West Sussex was listed as the hospital with the worst prevalence rate in the country for MRSA infections, in figures published today on the Department of Health website.

But the Queen Victoria hospital NHS trust said that the figures were inaccurate - and that none of the patients listed in the table were infected at the hospital but instead were reinfected or transferred from elsewhere.

While the overall rate of MRSA cases appears to be on the wane, a breakdown of individual hospitals showed significant variations, with hospitals delivering specialist care more likely to have higher prevalence rates.

The second and third worst ranking were two fellow specialist trusts, Brighton and Sussex University hospitals NHS trust and University Hospital Birmingham NHS trust.

This partly reflects the number of vulnerable patients undertaking more invasive and high risk specialist care in these hospitals. The greater the number of patients seen in specialist units, the greater their vulnerability to infection, and the higher resulting MRSA rates are likely to be.

While general acute trusts provide general healthcare services, single speciality trusts also provide one speciality, such as children's cancer services. Speciality trusts deliver specialist services to patients referred from other trusts.

The MRSA rate league table ranks hospitals according to the number of patients infected by MRSA for every thousand bed days.

The overall number of MRSA (methicillin resistant Staphylococcus aureus) cases in England fell by to 3,519 for the April-September 2004 period, down from 3,744 over the same period last year.

While Queen Victoria hospital was recorded as having only five MRSA cases reported in the first and second quarter of last year, its prevalence rate was the worst at 0.38 cases per thousand bed days.

The number of MRSA cases reported by Brighton and Sussex University NHS trust and University Birmingham NHS trust was far higher, at 70 and 65 respectively, but this reflected a nominally lower prevalence rate of 0.37 per thousand bed days.

But the Queen Victoria hospital (QVH) foundation trust, which provides specialist services for the South-east Thames region and bordering territory, challenged today's figures.

It claimed that only three, not five, patients in question had the superbug, which they contracted prior to being admitted to the trust for specialist treatment. Two of the patients concerned became reinfected. "Not a single patient was therefore infected with MRSA at QVH," a statement issued today said.

The trust also stressed that the appearance of a high prevalence rate was in part due to the size of the trust (130 beds) and its low bed occupancy.

"The Queen Victoria hospital NHS foundation trust in East Grinstead has an excellent record in the management of hospital acquired infections," the statement read. "These new statistics, which have been in the public domain since November 2004, are misleading and grossly represent this record."

The government itself warned against comparing "one hospital with another" because the MRSA-reporting NHS trust may not necessarily be the site in which the patient acquired the infection.

This is because patients are often transferred to and from other hospitals to receive care in specialist units.

The figures only reflect serious MRSA infections detected in blood samples.

Separate figures published last week by the National Audit Office revealed that the number of deaths through MRSA had doubled over the past four years.

Karen Jennings, Unison's head of health, welcomed the figures showing an overall decline in MRSA rates.

"I am pleased too that [the health secretary] John Reid has recognised the hard work and commitment of all NHS staff in bring these figures down," she said.

"However MRSA is still a very real problem and we must ensure that Infection control remains a high priority for the NHS. If we are really going to tackle the superbugs we must have good cleaning services and to do that we need to increase the number of cleaning staff on the wards."