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Healthcare Associated Infections (HCAIs) and Antimicrobial resistance (AMR)

A National Infection Control Action Plan – "Say No to Infection" was launched by HSE in March 2007. Its aim is to reduce HCAIs by 20%, MRSA infection by 30% and antibiotic consumption by 20% over the period of the Plan. There was a 48% decrease in notified cases of MRSA between 2006 and 2010 (from 592 to 305 cases). As a percentage of overall s.aureas isolates this represents a drop from 41.9% to 24.4%.
Data on acute hospital antibiotic consumption collected by the Health Protection Surveillance Centre (HPSC) showed a decrease in antibiotic consumption in 2008 for the first time since 2000; the decrease continued in 2009. However, statistics for 2010 show a 4% rise over 2009 rates (in all categories of hospitals) and a 6% increase for the first half of 2011(but a decrease in specialist hospitals within this statistic).
Publication in May 2009 of HIQA National Standards for the Prevention and Control of HCAIs; the HSE is working with HIQA to ensure that its healthcare facilities meet the requirements set down in the Standards.
The HSE established a Clinical Programme in HCAIs in 2011. A National Clinical Lead on HCAIs was jointly appointed by the RCPI and the HSE in early 2011 within the HSE's Directorate of Quality and Safety. The Chief Medical Officer’s (CMO's) Office is represented on the Steering Group.
A National Surveillance System was established by the HSE to collect data and provide information on a quarterly basis to monitor HCAIs. Since May 2008, Clostridium difficile (C. difficile) is a notifiable disease: all cases to be reported to the relevant Department of Public Health. Guidelines for the Surveillance, Management and Control of C. difficile-associated disease were published by the Health Protection Surveillance Centre (HPSC) in May 2008;
Carbapenem Resistant Enterobacteriaceae (CRE) has been added to the list of notifiable diseases with effect from 21st September, 2011 and draft interim guidelines have been circulated pending the issue of formal guidelines.
The HPSC liaises with its colleagues in the European Centre for Disease Control (ECDC) on all aspects of HCAIs and AMR.
The HSE supports the annual WHO Save Lives: Clean Your Hands Initiative each May and also participates in the annual European Antibiotic Awareness Day which takes place on 18th. The latter is a Europe-wide initiative to highlight the importance of using antibiotics wisely and preventing antibiotic resistance. This is a project of the (ECDC) and is supported by the European Parliament. The ECDC has been working in close collaboration with the Institutions of the European Union, member state authorities, the World Health organisation and many representative groups.

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