SAB in public hospitals

Over 600 public hospitals reported a total of 1,493 SAB cases.

82%25 of cases were treatable with commonly used antibiotics.

There were 0.73 SAB cases per 10,000 patient days in 2017–18.

Scope of public hospital SAB data in this report

Data in this report relating to numbers of cases and rates of S. aureus bloodstream infections exclude public hospitals where there were no SAB surveillance arrangements, as well as some public hospital services supplied by private hospitals. Data relating to individual public hospitals with SAB surveillance arrangements where services are supplied by private providers are available from the MyHospitals website.

In 2017–18:

  • There were 1,493 cases of SAB occurring during 20.5 million days of patient care under surveillance. Patient days under SAB surveillance covered 98% of days of patient care in public hospitals.
  • Overall, there were 0.73 SAB cases per 10,000 patient days.
  • 82% of SAB cases were methicillin-sensitive (MSSA), and therefore treatable with commonly used antimicrobials.

Changes in SAB rates over time

7.9%25 decrease in SAB cases over the past 5 years.

This is a decrease from 0.89 cases per 10,000 days of patient care in 2013-14 to 0.73 in 2017-18.

The proportion of cases treatable with commonly-used antibiotics increased from 76%25 to 82%25.

 

Figure PB1 and Table PB1 show changes in SAB rates between 2013–14 and 2017–18.

Figure PB1. SAB in public hospitals, MRSA, MSSA and total SAB rates, 2013–14 to 2017–18

Table PB1. SAB cases and rates in public hospitals, MSSA and MRSA, 2013–14 to 2017–18

 

2013–14

2014–15

2015–16

2016–17

2017–18

Cases

MSSA

1,233

1,160

1,172

1,211

1,226

MRSA

388

331

278

290

267

Total

1,621

1,491

1,450

1,501

1,493

Cases per 10,000 patient days

MSSA

0.67

0.62

0.60

0.61

0.60

MRSA

0.21

0.18

0.14

0.15

0.13

Total

0.89

0.79

0.74

0.76

0.73

 

Patient days under surveillance (‘000)

18,298.4

18,825.0

19,608.1

19,833.8

20,453.2

Coverage rate (%)

98

98

98

98

98

Source: AIHW National Staphylococcus aureus Bacteraemia Data Collection. 

SAB cases and rates in states and territories

Figure PB2. SAB cases and rates in public hospitals, states and territories, 2013–14 to 2017–18

Table PB2. SAB cases and rates in public hospitals, MSSA and MRSA, states and territories. 2017–18

 

MSSA

MRSA

Total SAB cases

Patient days under surveillance

Coverage

 

rate (a)

rate (a)

cases

rate (a)

‘000

%

NSW

0.56

0.17

530

0.72

7,336.3

97

Vic

0.64

0.13

402

0.77

5,240.5

99

Qld

0.57

0.06

239

0.62

3,832.8

100

WA

0.71

0.12

121

0.83

1,466.5

97

SA

0.67

0.16

119

0.83

1,430.3

94

Tas

0.73

0.12

36

0.85

422.1

100

ACT

0.74

0.08

30

0.82

365.3

98

NT

0.19

0.25

16

0.45

359.4

100

Total

0.60

0.13

1,493

0.73

20,453.2

98

(a) Cases per 10,000 patient days.

Source: AIHW National Staphylococcus aureus Bacteraemia Data Collection.

 

  • For each state and territory, and at the national level, the 2017–18 SAB rate was lower than the national benchmark of 2.0 cases per 10,000 patient days.
  • SAB rates in 2017–18 ranged from 0.45 in the Northern Territory to 0.85 in Tasmania.
  • Between 2013–14 and 2017–18 SAB rates decreased in New South Wales, Victoria and Queensland, and fluctuated in other states and territories.

  • Differences in SAB rates between jurisdictions may reflect differences in surveillance and validation processes.

SAB rates by type of public hospital

Principal referral hospitals and Public acute group A hospitals can be more likely to treat patients at risk of SAB than other hospitals, and therefore tend to have higher proportions of SAB cases and higher SAB rates.

Hospital peer groups

Principal referral hospitals (‘Major hospitals’ on MyHospitals) provide a very broad range of services, have a range of highly specialised service units, and have very large patient volumes. The term ‘referral’ recognises that these hospitals have specialist facilities not typically found in smaller hospitals.

Public acute group A hospitals (‘Large hospitals’ on MyHospitals) generally provide a wide range of services, but narrower than Principal referral hospitals. While complex patients may be treated, they are usually less complex than those seen in Principal referral hospitals.

Public acute group B hospitals (‘Medium hospitals’ on MyHospitals) provide a narrower range of services, and are less likely to treat complex patients than either Principal referral or Public acute group A hospitals.

Children’s hospitals specialise in the treatment and care of children. For the purposes of this report and its associated data, children’s hospitals include Combined women and children’s hospitals (that is, those specialising in the treatment of both women and children.

For more information on public hospital peer groups, see Australian hospital peer groups (AIHW 2015).

Four out of every five public hospital SAB cases recorded in 2017–18 occurred in Principal referral or Public acute group A hospitals.

  • Half of all SAB cases occurred in Principal referral hospitals, while 30% occurred in Public acute group A hospitals.
  • A further 6% occurred in Public acute group B hospitals.

The SAB rate across all Principal referral hospitals was 1.01 cases per 10,000 patient days. In comparison, the rate across all Public acute group A hospitals was 0.73 cases per 10,000 patient days and the rate across all Public acute group B hospitals was 0.51 cases per 10,000 patient days. The SAB rate across all Children’s hospitals was 1.44 cases per 10,000 patient days.

A data visualisation allowing exploration of SAB rates in individual public hospitals by peer group is available on the MyHospitals website.

Figure PB3. SAB rates in public hospitals, MSSA and MRSA rates, peer groups, states and territories, 2017–18

SAB in private hospitals

Currently, private hospitals participate in the NSABDC on a voluntary basis, and coverage of SAB cases and rates in the private sector is therefore incomplete. Data reported by participating private hospitals may not be representative of the private sector as a whole. The case mix of patients treated in private hospitals may also be different to that in public hospitals.

The rate of private hospital participation in the NSABDC for 2017–18 is calculated using counts of all private hospitals from the 2016–17 Private Health Establishments Collection of the Australian Bureau of Statistics (ABS 2018).

 24%25 of private hospitals provided data for 2017-18.

160 private hospitals reported a total of 209 cases.

In 2017–18:

  • As shown in Table PV1, about one in four private hospitals (160, or 24%)1 participated in the NSABDC. This is similar to overall participation figures for the 2016–17 NSABDC (89 private hospitals having provided data by the time of the previous AIHW report, with around 60 more submitting data in the following months for inclusion  on the MyHospitals website).
  • Private hospitals participating in the 2017–18 NSABDC included 3 that also provided public hospital services. These are shown as public hospitals on MyHospitals.
  • A total of 204 cases of SAB were reported by private hospitals.
  • All private hospitals reporting SAB data had rates below the national benchmark1.
  • The total SAB rate for all private hospitals participating in the 2017–18 NSABDC was 0.33 cases per 10,000 patient days. Note the SAB rates in private hospitals choosing to participate in the collection might not be representative of private hospitals as a whole and therefore are not readily comparable to public hospitals.
  • Amongst the 65 private hospitals that reported 1 or more SAB cases in 2017–18, SAB rates ranged from 0.11 cases per 10,000 patient days to 1.84 cases per 10,000 patient days1.
  • 30 of the private hospitals reporting 1 more SAB cases provided separate counts of MSSA and MRSA cases. Among these hospitals, rates of MSSA ranged from 0 to 1.84 and rates of MRSA ranged from 0 to 0.411.

Counts and rates for individual private hospitals participating in the NSABDC are provided on MyHospitals.

Notes

1. Includes 4 private hospitals that provided SAB rates but did not provide counts of SAB cases or patient days.

Table PV1. Participation in SAB reporting among private hospitals, states and territories, 2017–18

 

Private hospitals participating in 2017–18 NSABDC (a)

no.

Private hospitals listed as such in 2016–17

no.

Participation rate

%

NSW

48

210

23

Vic

52

174

29

Qld

29

118

25

WA

15

64

23

SA

12

56

21

Tas, ACT & NT (b)

4

35

11

Total

160

657

24
  1. Includes some public hospital services supplied by private providers.
  2. Figures for Tasmania, the Australian Capital Territory and the Northern Territory were combined to protect the confidentiality of the small numbers of private hospitals in these jurisdictions.

Source: AIHW National Staphylococcus aureus Bacteraemia Data Collection and ABS Private Health Establishments Collection (ABS 2018).

References