Public Health England Report Pseudomonas Incidents By Hospital Trust 2021

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Publication date: Wednesday 15 September 2021

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What this file contains:

Results by NHS acute trust and CCG

Financial year counts and rates of P. aeruginosa bacteraemia by NHS acute trust and CCG by onset status (April 2017 to March 2021). 

What this data shows:

§annual counts and rates (per 100,000 overnight bed days) of P. aeruginosa bacteraemia by acute trust and onset status
§annual counts and rates (per 100,000 population) of P. aeruginosa bacteraemia by CCG and onset status
§denominator by NHS acute trust and CCG

What this data does not provide:

§a basis for decisions on the clinical effectiveness of infection control interventions in individual Trusts: further investigations considering potential confounders would need to be undertaken before this could be done
§a basis for comparisons between acute Trust or CCGs.  Rate information, using rate calculations as currently defined, is not appropriate for comparison. The counts of infections have not been adjusted to give a standardised rate considering factors such as organisational demographics or case mix. Rate information is of use for comparison of an individual organisation over time

Calculation of rate per 100,000 acute Trust bed days:

§bed days were calculated using KH03 data for the stated period. The average daily bed occupancy for the Trust quoted has been multiplied by the number of days in the time period
§the relevant rate per 100,000 bed days (either total cases or Trust apportioned cases only) was calculated as follows:

 Rate, per 100,000 overnight bed-days=((n new cases reported by trust)/(Average daily occupancy×n days in period))×100,000

All reported cases:

§‘all reported cases’ refers to all P. aeruginosa -positive blood cultures reported by the Trust whose laboratory processes the specimen. It is important to note that this may not always reflect where the bacteraemia was acquired.

Onset status of cases:

P. aeruginosa bacteraemia infections are deemed to be hospital-onset if the following rules are met:

i.the location where the specimen was taken is given as ‘acute trust’ or is not known
ii.the patient was either an ‘In-patient’, ‘Day-patient’, in ‘Emergency assessment’ or is not known
iii.patient’s specimen date is on, or after, the third day of the admission (or admission date is null), where the day of admission is day 1

If the above rules are not met, then cases are deemed to be community-onset.

Calculation of rate per 100,000 CCG population:

§CCG Populations are based upon Office for National Statistics (ONS) Mid-Year Population Estimates (2011 Census based)
§the relevant rate per 100,000 population was calculated as follows:

Rate, per 100,000 population=((n new cases attributed to CCG)/(Financial year population))×100,000

Note that a rate cannot be calculated for Specialist Commissioning Hubs as they commission services from across England thus an appropriate population denominator is not available.

CCG attributing of cases

All reported MSSA bacteraemia cases are attributed to a CCG.

The NHS Digial Demographics Batch Service (DBS) and Organisation Data Service (ODS) are used to attribute P. aeruginosabacteraemias.  The CCG for each case is attributed, in the following order:

§if patient’s GP practice code is available (and is based in England), the case will be attributed to the CCG at which the patient’s GP is listed
§if the patient’s GP practice code is unavailable but the patient is known to reside in England, the case is attributed to the CCG catchment area in which the patient resides
§if both the patient’s GP practice code and patient post code are unavailable or if patient has been identified as residing outside England, then the case is attributed to CCG based upon the postcode of the HQ of the acute Trust that reported the case

Note that the retrospective attribution of cases to a CCG may become less accurate the older the data thus the data contained in this table should be treated with caution and used as an indication of the trend over time for a given CCG.

Data source:

§data were extracted from PHE’s data capture system on 27 April 2021
§changes and updates to the data after this date will be reflected in the next publication
§data are collected at Trust level
§data are reported for 140 acute Trusts and 135 CCGs.
§dases are reported by the Trust whose laboratory processes the specimen, which may not always reflect where the MSSA bacteraemia was acquired.

Key to Trust type (as at May 2021)

FT – Foundation Trust

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