Decline in 30-day all-cause mortality following health care-associated infections

  • Public Health England
  • 14 Jan 2021

  • curated by Dawn O'Shea
  • UK Medical News
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New statistics from Public Health England demonstrate a significant decline in all-cause deaths following healthcare-associated infections.

Between 2007-2008 and 2019-2020, the number of 30-day all-cause deaths after meticillin-resistant Staphylococcus aureus (MRSA) bacteraemia fell from 1354 to 201 deaths. The number for Clostridioides difficile infection (CDI) decreased from 13,973 to 1735 deaths. The decline has been attributed to decreasing incidence of these infections.

The data show that in 2019-2020 (April 2019 to March 2020), 30-day all-cause mortality rates per 100,000 population were:

  • (Escherichia coli bacteraemia (10.7; n=6005 deaths).
  • Meticillin-susceptible S aureus bacteraemia (4.1; n=2299 deaths).
  • Klebsiella spp. bacteraemia (3.6; n=2042 deaths).
  • CDI (3.1; n=1735 deaths).
  • Pseudomonas aeruginosa bacteraemia (1.8; n=1031 deaths).
  • MRSA bacteraemia (0.4; n=201 deaths).

In contrast, the number of deaths following MSSA bacteraemia (1777 deaths in 2011-2012 to 2299 in 2019-20) and E coli bacteraemia (5163 deaths in 2012-2013 to 6005 in 2019-2020) have increased, reflecting the continuing rise in the incidence of these infections.

In 2019-2020, case fatality rates (CFRs) were:

  • MRSA bacteraemia (25.7%).
  • P aeruginosa bacteraemia (24.5%).
  • MSSA bacteraemia (19.5%).
  • Klebsiella spp. bacteraemia (19.1%)
  • E coli bacteraemia (14.3%).
  • CDI (13.5%).

The data reveal that the overall trend in CFRs for each infection has declined, despite the increases in overall numbers for some, with statistically significant reductions in CFR between the current year and the start of mandatory surveillance of each infection.

This suggests that despite continued increases in the incidence of infections like MSSA and E coli bacteraemia, a greater proportion of patients are surviving each type of infection over time.