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

There is increasing interest in the surveillance of hospital-acquired infection (HAI) in the Republic of Ireland due to a greater awareness of the consequences of antibiotic resistance, and consumer pressure in the form of public expectations of the quality of health care. To date there have been no nationwide prospective surveillance projects but surveillance has taken place in the form of participation in international and national studies, and the description of local outbreaks. Infection control teams and others have participated in projects such as a European study of HAI in intensive care units conducted in 1992, the second national prevalence study conducted in the UK in 1993 and two surveys of methicillin-resistant Staphylococcus aureus (MRSA) carried out in 1995 and 1999, the latter involving colleagues in Northern Ireland. There have been a number of local surveys of antibiotic-resistant bacteria including the molecular characterization of MRSA in Dublin hospitals, vancomycin-resistant enterococci, and Gram-negative bacteria such as Enterobacter spp. and Serratia spp. affecting compromised patients such as bone marrow transplant recipients. In the future, it is hoped to standardize case definitions, 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 quality of health care in Irish hospitals, approximate costings suggest that there are potential savings of 7.5 pounds sterling -15 pounds sterling m to be made following a reduction of HAI rates of 15%. Copyright 2001 The Hospital Infection Society.