Surveillance of hospital-acquired infection in the Republic of Ireland: past, present and future

There is increasing interest in the surveillance of hospital-acquired infec tion (HAI) in the Republic of Ireland clue to a greater awareness of the co nsequences of antibiotic resistance, and consumer pressure in the form of p ublic expectations of the quality of health care. To date there have been n o nationwide prospective surveillance projects but surveillance has taken p lace in the form of participation in international and national studies, an d the description of local outbreaks. Infection control teams and others ha ve participated in projects such as a European study of HAI in intensive ca re units conducted in 1992, the second national prevalence study conducted in the UK in 1993 and two surveys of methicillin-resistant Staphylococcus a ureus (MRSA) carried out in 1995 and 1999, the latter involving colleagues in Northern Ireland. There have been a number of local surveys of antibioti c-resistant bacteria including the molecular characterization of MRSA in Du blin hospitals, vancomycin-resistant enterococci, and Gram-negative bacteri a such as Enterobacter spp. and Serratia spp. affecting compromised patient s such as bone marrow-transplant recipients. In the future, it is hoped to standardize case definition,;, automate data entry, increase collaboration with surveillance initiatives in Northern Ireland and link in with European networks such as EARSS and HELICS. Apart from the need to improve the qual ity of health care in Irish hospitals, approximate costings suggest that th ere are potential savings of pound7.5-pound 15 in to be made following a re duction of HAI rates of 15%. (C) 2001 The Hospital Infection Society.