Investigation launched into C.difficile deaths at Welsh hospital

Wrexham Maelor Hospital death rates soar despite a drop in overall infection rates

Hospitals are stepping up infection control measures following the Pseudomonas outbreak in Northern Ireland

An investigation is underway after seven patients died of C.difficile infections over a two-month period at Wrexham Maelor Hospital in North Wales.

The cases were reported in September and October, with death rates almost twice as high as at neighbouring Glan Clwyd Hospital and Ysbyty Gwynedd, despite those two centres reporting a higher overall prevalence of the bug.

The finding of concern is that in Wrexham Maelor Hospital the proportion of total deaths and deaths within 30 days of C.difficile infection is almost twice as high as in the other two hospitals

Earlier this year the Betsi Cadwaladr University Health Board was strongly criticised for its handling of an outbreak of the infection at Glan Clwyd after 96 cases were recorded between January and May, resulting in 30 deaths.

And in a report to a recent board meeting, Tracey Cooper, assistant director of nursing who has been appointed to have special responsibility for infection prevention, outlines the measures taken to tackle the problem and prevent a recurrence.

She said extra staff have been taken on to work in the infection control team, and rapid review audits are being carried out of hand hygiene, isolation practice and commode cleanliness when C.difficile is detected.

But the report reveals an upturn in the number of new cases across North Wales, with 47 cases reported in October. Of those, four were at Wrexham, 12 in Glan Clwyd, 11 in Ysbyty Gwynedd and 20 at non-acute sites.

One ward in Ysbyty Gwynedd and one at Glan Clwyd had a period of increased incidence which prompted intensive intervention by the infection control team.

It is still of sufficient concern to require the full investigation to continue in line with PHW recommendations

The board has received a further report from Public Health Wales (PHW) covering the period from January 2012, to June 2013, showing the rate of infection in the Maelor Hospital in the first half of this year to be significantly lower than in 2012 and also lower than at the other two general hospitals.

“The finding of concern is that in Wrexham Maelor Hospital the proportion of total deaths and deaths within 30 days of C.difficile infection is almost twice as high as in the other two hospitals,“ says the report.

“The mortality rate is much higher than it was in 2012 and coincides with a large decrease in numbers of patients with C.difficile infection on the site.”

The percentage of C.difficile patients who died was 57 per c% t in Wrexham, 30% in Glan Clwyd and 34% in Bangor.

Steps that have been taken to address the problem include review of specimen collection practices, support for a review of practices at the Wrexham microbiology laboratory, and a casenote review by Public Health Wales of the 23 patients affected in Wrexham between January and June.

But Cooper said: “It is still of sufficient concern to require the full investigation to continue in line with PHW recommendations.”

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